| National Provider Identifier [NPI]: | 1134127723 |
| Last Name Of The Provider | KOZLOWSKI |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1521 S STAPLES ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CORPUS CHRISTI |
| Zip Code Of The Provider | 784043150 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 283 |
| Number Of Services | 8945 |
| Number Of Medicare Beneficiaries | 2548 |
| Total Submitted Charge Amount | 835139.5 |
| Total Medicare Allowed Amount | 252657.02 |
| Total Medicare Payment Amount | 192644.76 |
| Total Medicare Standardized Payment Amount | 203244.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 3212 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 2185 |
| Total Drug Medicare AllowedAmount | 889.45 |
| Total Drug Medicare PaymentAmount | 697.31 |
| Total Drug Medicare Standardized Payment Amount | 697.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 278 |
| Number Of Medical Services | 5733 |
| Number Of Medicare Beneficiaries With Medical Services | 2548 |
| Total Medical Submitted Charge Amount | 832954.5 |
| Total Medical Medicare Allowed Amount | 251767.57 |
| Total Medical Medicare Payment Amount | 191947.45 |
| Total Medical Medicare Standardized Payment Amount | 202547.51 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 529 |
| Number Of Beneficiaries Age 65 to 74 | 884 |
| Number Of Beneficiaries Age 75 to 84 | 700 |
| Number Of Beneficiaries Age Greater 84 | 435 |
| Number Of Female Beneficiaries | 1408 |
| Number Of Male Beneficiaries | 1140 |
| Number Of Non Hispanic White Beneficiaries | 1473 |
| Number Of Black or African American Beneficiaries | 69 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 975 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1765 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 783 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.2161 |