| National Provider Identifier [NPI]: | 1255387841 |
| Last Name Of The Provider | PODACH |
| First Name Of The Provider | DANITA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PAC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 60 WASHINGTON BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | KENTON |
| Zip Code Of The Provider | 433262080 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 1036 |
| Number Of Medicare Beneficiaries | 298 |
| Total Submitted Charge Amount | 76429 |
| Total Medicare Allowed Amount | 35379.03 |
| Total Medicare Payment Amount | 25840.31 |
| Total Medicare Standardized Payment Amount | 32591.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 287 |
| Number Of Medicare Beneficiaries With Drug Services | 59 |
| Total Drug Submitted ChargeAmount | 1693 |
| Total Drug Medicare AllowedAmount | 656.17 |
| Total Drug Medicare PaymentAmount | 535.74 |
| Total Drug Medicare Standardized Payment Amount | 535.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 749 |
| Number Of Medicare Beneficiaries With Medical Services | 298 |
| Total Medical Submitted Charge Amount | 74736 |
| Total Medical Medicare Allowed Amount | 34722.86 |
| Total Medical Medicare Payment Amount | 25304.57 |
| Total Medical Medicare Standardized Payment Amount | 32056.18 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 126 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 204 |
| Number Of Male Beneficiaries | 94 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 47 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.11 |