| National Provider Identifier [NPI]: | 1679517528 |
| Last Name Of The Provider | SOWELL |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3316 N UNIVERSITY DR |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | NACOGDOCHES |
| Zip Code Of The Provider | 759652632 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 4282 |
| Number Of Medicare Beneficiaries | 1212 |
| Total Submitted Charge Amount | 671468 |
| Total Medicare Allowed Amount | 255643.31 |
| Total Medicare Payment Amount | 184047.75 |
| Total Medicare Standardized Payment Amount | 199243.06 |
| 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 | 42 |
| Number Of Medical Services | 4282 |
| Number Of Medicare Beneficiaries With Medical Services | 1212 |
| Total Medical Submitted Charge Amount | 671468 |
| Total Medical Medicare Allowed Amount | 255643.31 |
| Total Medical Medicare Payment Amount | 184047.75 |
| Total Medical Medicare Standardized Payment Amount | 199243.06 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 138 |
| Number Of Beneficiaries Age 65 to 74 | 300 |
| Number Of Beneficiaries Age 75 to 84 | 380 |
| Number Of Beneficiaries Age Greater 84 | 394 |
| Number Of Female Beneficiaries | 782 |
| Number Of Male Beneficiaries | 430 |
| Number Of Non Hispanic White Beneficiaries | 961 |
| Number Of Black or African American Beneficiaries | 234 |
| 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 | 676 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 536 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 42 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8655 |