| National Provider Identifier [NPI]: | 1952698045 |
| Last Name Of The Provider | FOWLER |
| First Name Of The Provider | COLEATHA |
| Middle Initial Of The Provider | Z |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11990 JACKSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLINTON |
| Zip Code Of The Provider | 707223210 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 154 |
| Number Of Medicare Beneficiaries | 77 |
| Total Submitted Charge Amount | 2982 |
| Total Medicare Allowed Amount | 1760.55 |
| Total Medicare Payment Amount | 1669.51 |
| Total Medicare Standardized Payment Amount | 1913.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 43 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 1283 |
| Total Drug Medicare AllowedAmount | 634.92 |
| Total Drug Medicare PaymentAmount | 609.03 |
| Total Drug Medicare Standardized Payment Amount | 609.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 111 |
| Number Of Medicare Beneficiaries With Medical Services | 76 |
| Total Medical Submitted Charge Amount | 1699 |
| Total Medical Medicare Allowed Amount | 1125.63 |
| Total Medical Medicare Payment Amount | 1060.48 |
| Total Medical Medicare Standardized Payment Amount | 1304.95 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 24 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 45 |
| Number Of Male Beneficiaries | 32 |
| Number Of Non Hispanic White Beneficiaries | 48 |
| 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 | 40 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1113 |