National Provider Identifier [NPI]: |
1285731695 |
Last Name Of The Provider |
POLLAK |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3601 W 13 MILE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROYAL OAK |
Zip Code Of The Provider |
480736712 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
73 |
Number Of Services |
403 |
Number Of Medicare Beneficiaries |
349 |
Total Submitted Charge Amount |
587120 |
Total Medicare Allowed Amount |
54685.01 |
Total Medicare Payment Amount |
42376.15 |
Total Medicare Standardized Payment Amount |
41236.11 |
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 |
73 |
Number Of Medical Services |
403 |
Number Of Medicare Beneficiaries With Medical Services |
349 |
Total Medical Submitted Charge Amount |
587120 |
Total Medical Medicare Allowed Amount |
54685.01 |
Total Medical Medicare Payment Amount |
42376.15 |
Total Medical Medicare Standardized Payment Amount |
41236.11 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
147 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
176 |
Number Of Male Beneficiaries |
173 |
Number Of Non Hispanic White Beneficiaries |
267 |
Number Of Black or African American Beneficiaries |
68 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
292 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0426 |