National Provider Identifier [NPI]: |
1922086784 |
Last Name Of The Provider |
BOWEN |
First Name Of The Provider |
KRISTINA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1100 JOHNSON FERRY RD NE |
Street Address 2 Of The Provider |
SUITE 600 |
City Of The Provider |
SANDY SPRINGS |
Zip Code Of The Provider |
303421709 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
572 |
Number Of Medicare Beneficiaries |
326 |
Total Submitted Charge Amount |
128968 |
Total Medicare Allowed Amount |
32566.11 |
Total Medicare Payment Amount |
23252.18 |
Total Medicare Standardized Payment Amount |
23231.23 |
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 |
17 |
Number Of Medical Services |
572 |
Number Of Medicare Beneficiaries With Medical Services |
326 |
Total Medical Submitted Charge Amount |
128968 |
Total Medical Medicare Allowed Amount |
32566.11 |
Total Medical Medicare Payment Amount |
23252.18 |
Total Medical Medicare Standardized Payment Amount |
23231.23 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
207 |
Number Of Beneficiaries Age 75 to 84 |
79 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
301 |
Number Of Male Beneficiaries |
25 |
Number Of Non Hispanic White Beneficiaries |
280 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
313 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
75 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
15 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2172 |