National Provider Identifier [NPI]: |
1134181944 |
Last Name Of The Provider |
KOWALSKE |
First Name Of The Provider |
KAREN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5323 HARRY HINES BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
753907208 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1634 |
Number Of Medicare Beneficiaries |
362 |
Total Submitted Charge Amount |
348759 |
Total Medicare Allowed Amount |
123098.21 |
Total Medicare Payment Amount |
93988.38 |
Total Medicare Standardized Payment Amount |
94674.79 |
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 |
21 |
Number Of Medical Services |
1634 |
Number Of Medicare Beneficiaries With Medical Services |
362 |
Total Medical Submitted Charge Amount |
348759 |
Total Medical Medicare Allowed Amount |
123098.21 |
Total Medical Medicare Payment Amount |
93988.38 |
Total Medical Medicare Standardized Payment Amount |
94674.79 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
110 |
Number Of Beneficiaries Age 65 to 74 |
135 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
181 |
Number Of Male Beneficiaries |
181 |
Number Of Non Hispanic White Beneficiaries |
231 |
Number Of Black or African American Beneficiaries |
79 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
250 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
112 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
45 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
59 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.7871 |