| National Provider Identifier [NPI]: | 1376590091 |
| Last Name Of The Provider | SADIKOV |
| First Name Of The Provider | POLINA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9000 N MAIN ST |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | DAYTON |
| Zip Code Of The Provider | 454151180 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 5517 |
| Number Of Medicare Beneficiaries | 297 |
| Total Submitted Charge Amount | 246224 |
| Total Medicare Allowed Amount | 157307.55 |
| Total Medicare Payment Amount | 117673.19 |
| Total Medicare Standardized Payment Amount | 122492.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 2566 |
| Number Of Medicare Beneficiaries With Drug Services | 190 |
| Total Drug Submitted ChargeAmount | 73250 |
| Total Drug Medicare AllowedAmount | 43431.03 |
| Total Drug Medicare PaymentAmount | 36031.18 |
| Total Drug Medicare Standardized Payment Amount | 36031.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 2951 |
| Number Of Medicare Beneficiaries With Medical Services | 297 |
| Total Medical Submitted Charge Amount | 172974 |
| Total Medical Medicare Allowed Amount | 113876.52 |
| Total Medical Medicare Payment Amount | 81642.01 |
| Total Medical Medicare Standardized Payment Amount | 86461.56 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | 84 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 211 |
| Number Of Male Beneficiaries | 86 |
| Number Of Non Hispanic White Beneficiaries | 263 |
| Number Of Black or African American Beneficiaries | |
| 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 | 251 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0501 |