| National Provider Identifier [NPI]: | 1306874599 |
| Last Name Of The Provider | FOWLER |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 225 N JACKSON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN JOSE |
| Zip Code Of The Provider | 951161603 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 1985 |
| Number Of Medicare Beneficiaries | 798 |
| Total Submitted Charge Amount | 504431 |
| Total Medicare Allowed Amount | 155225.89 |
| Total Medicare Payment Amount | 119232.89 |
| Total Medicare Standardized Payment Amount | 109143.39 |
| 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 | 68 |
| Number Of Medical Services | 1985 |
| Number Of Medicare Beneficiaries With Medical Services | 798 |
| Total Medical Submitted Charge Amount | 504431 |
| Total Medical Medicare Allowed Amount | 155225.89 |
| Total Medical Medicare Payment Amount | 119232.89 |
| Total Medical Medicare Standardized Payment Amount | 109143.39 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 149 |
| Number Of Beneficiaries Age 65 to 74 | 209 |
| Number Of Beneficiaries Age 75 to 84 | 268 |
| Number Of Beneficiaries Age Greater 84 | 172 |
| Number Of Female Beneficiaries | 446 |
| Number Of Male Beneficiaries | 352 |
| Number Of Non Hispanic White Beneficiaries | 338 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | 221 |
| Number Of Hispanic Beneficiaries | 190 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 312 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 486 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9644 |