| National Provider Identifier [NPI]: | 1679567663 |
| Last Name Of The Provider | GLOWACKI |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5950 UNIVERSITY AVE |
| Street Address 2 Of The Provider | STE 341 |
| City Of The Provider | WEST DES MOINES |
| Zip Code Of The Provider | 502668216 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 5504 |
| Number Of Medicare Beneficiaries | 1210 |
| Total Submitted Charge Amount | 1611787.95 |
| Total Medicare Allowed Amount | 561639.83 |
| Total Medicare Payment Amount | 427173.24 |
| Total Medicare Standardized Payment Amount | 448846.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 1399 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 625377 |
| Total Drug Medicare AllowedAmount | 236528.08 |
| Total Drug Medicare PaymentAmount | 184040.17 |
| Total Drug Medicare Standardized Payment Amount | 184040.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 111 |
| Number Of Medical Services | 4105 |
| Number Of Medicare Beneficiaries With Medical Services | 1210 |
| Total Medical Submitted Charge Amount | 986410.95 |
| Total Medical Medicare Allowed Amount | 325111.75 |
| Total Medical Medicare Payment Amount | 243133.07 |
| Total Medical Medicare Standardized Payment Amount | 264806.07 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 525 |
| Number Of Beneficiaries Age 75 to 84 | 425 |
| Number Of Beneficiaries Age Greater 84 | 167 |
| Number Of Female Beneficiaries | 295 |
| Number Of Male Beneficiaries | 915 |
| Number Of Non Hispanic White Beneficiaries | 1153 |
| Number Of Black or African American Beneficiaries | 28 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1084 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 126 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1783 |