National Provider Identifier [NPI]: |
1750491130 |
Last Name Of The Provider |
DOWELL |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11477 OLDE CABIN RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631417130 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
944 |
Number Of Medicare Beneficiaries |
276 |
Total Submitted Charge Amount |
176150 |
Total Medicare Allowed Amount |
94845.55 |
Total Medicare Payment Amount |
65224.98 |
Total Medicare Standardized Payment Amount |
67613.08 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
8 |
Number Of Medical Services |
944 |
Number Of Medicare Beneficiaries With Medical Services |
276 |
Total Medical Submitted Charge Amount |
176150 |
Total Medical Medicare Allowed Amount |
94845.55 |
Total Medical Medicare Payment Amount |
65224.98 |
Total Medical Medicare Standardized Payment Amount |
67613.08 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
90 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
163 |
Number Of Male Beneficiaries |
113 |
Number Of Non Hispanic White Beneficiaries |
257 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
227 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0764 |