| National Provider Identifier [NPI]: | 1629048350 |
| Last Name Of The Provider | POLAN |
| First Name Of The Provider | RUTH |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 227 W JANSS RD |
| Street Address 2 Of The Provider | SUITE 150 |
| City Of The Provider | THOUSAND OAKS |
| Zip Code Of The Provider | 913601848 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 186 |
| Number Of Services | 6702 |
| Number Of Medicare Beneficiaries | 2856 |
| Total Submitted Charge Amount | 931915 |
| Total Medicare Allowed Amount | 405420.75 |
| Total Medicare Payment Amount | 321459.5 |
| Total Medicare Standardized Payment Amount | 300682.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 901 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1087 |
| Total Drug Medicare AllowedAmount | 287.4 |
| Total Drug Medicare PaymentAmount | 206.78 |
| Total Drug Medicare Standardized Payment Amount | 206.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 183 |
| Number Of Medical Services | 5801 |
| Number Of Medicare Beneficiaries With Medical Services | 2856 |
| Total Medical Submitted Charge Amount | 930828 |
| Total Medical Medicare Allowed Amount | 405133.35 |
| Total Medical Medicare Payment Amount | 321252.72 |
| Total Medical Medicare Standardized Payment Amount | 300475.61 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 175 |
| Number Of Beneficiaries Age 65 to 74 | 1034 |
| Number Of Beneficiaries Age 75 to 84 | 953 |
| Number Of Beneficiaries Age Greater 84 | 694 |
| Number Of Female Beneficiaries | 1881 |
| Number Of Male Beneficiaries | 975 |
| Number Of Non Hispanic White Beneficiaries | 2469 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | 125 |
| Number Of Hispanic Beneficiaries | 174 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 59 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2466 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 390 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6111 |