| National Provider Identifier [NPI]: | 1477870459 |
| Last Name Of The Provider | KOWALCZYK |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4495 MILITARY TRL |
| Street Address 2 Of The Provider | SUITE 204 |
| City Of The Provider | JUPITER |
| Zip Code Of The Provider | 334584839 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 5053 |
| Number Of Medicare Beneficiaries | 1163 |
| Total Submitted Charge Amount | 319167 |
| Total Medicare Allowed Amount | 242271.86 |
| Total Medicare Payment Amount | 188921.41 |
| Total Medicare Standardized Payment Amount | 177170.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 92 |
| Total Drug Medicare AllowedAmount | 40.78 |
| Total Drug Medicare PaymentAmount | 31.99 |
| Total Drug Medicare Standardized Payment Amount | 31.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 5030 |
| Number Of Medicare Beneficiaries With Medical Services | 1163 |
| Total Medical Submitted Charge Amount | 319075 |
| Total Medical Medicare Allowed Amount | 242231.08 |
| Total Medical Medicare Payment Amount | 188889.42 |
| Total Medical Medicare Standardized Payment Amount | 177138.76 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 501 |
| Number Of Beneficiaries Age 75 to 84 | 451 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 547 |
| Number Of Male Beneficiaries | 616 |
| Number Of Non Hispanic White Beneficiaries | 1130 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9423 |