| National Provider Identifier [NPI]: | 1922186733 |
| Last Name Of The Provider | DOWELL |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1450 E A ST STE 1 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CASPER |
| Zip Code Of The Provider | 826012239 |
| State Code Of The Provider | WY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 302203 |
| Number Of Medicare Beneficiaries | 718 |
| Total Submitted Charge Amount | 2185564.7 |
| Total Medicare Allowed Amount | 839395.28 |
| Total Medicare Payment Amount | 651650.04 |
| Total Medicare Standardized Payment Amount | 654787.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 28 |
| Number Of Drug Services | 297218 |
| Number Of Medicare Beneficiaries With Drug Services | 137 |
| Total Drug Submitted ChargeAmount | 1013349.7 |
| Total Drug Medicare AllowedAmount | 403498.64 |
| Total Drug Medicare PaymentAmount | 317041.44 |
| Total Drug Medicare Standardized Payment Amount | 317041.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 4985 |
| Number Of Medicare Beneficiaries With Medical Services | 718 |
| Total Medical Submitted Charge Amount | 1172215 |
| Total Medical Medicare Allowed Amount | 435896.64 |
| Total Medical Medicare Payment Amount | 334608.6 |
| Total Medical Medicare Standardized Payment Amount | 337746.55 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 188 |
| Number Of Beneficiaries Age 65 to 74 | 252 |
| Number Of Beneficiaries Age 75 to 84 | 203 |
| Number Of Beneficiaries Age Greater 84 | 75 |
| Number Of Female Beneficiaries | 385 |
| Number Of Male Beneficiaries | 333 |
| Number Of Non Hispanic White Beneficiaries | 655 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | 23 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 517 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 201 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 2.0104 |