National Provider Identifier [NPI]: |
1336107622 |
Last Name Of The Provider |
POLASA |
First Name Of The Provider |
SANGEETHA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2180 W STATE ROAD 434 |
Street Address 2 Of The Provider |
SUITE 2110 |
City Of The Provider |
LONGWOOD |
Zip Code Of The Provider |
327795041 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
4274 |
Number Of Medicare Beneficiaries |
583 |
Total Submitted Charge Amount |
1429741.24 |
Total Medicare Allowed Amount |
372431.77 |
Total Medicare Payment Amount |
285695 |
Total Medicare Standardized Payment Amount |
290505.26 |
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 |
20 |
Number Of Medical Services |
4274 |
Number Of Medicare Beneficiaries With Medical Services |
583 |
Total Medical Submitted Charge Amount |
1429741.24 |
Total Medical Medicare Allowed Amount |
372431.77 |
Total Medical Medicare Payment Amount |
285695 |
Total Medical Medicare Standardized Payment Amount |
290505.26 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
174 |
Number Of Beneficiaries Age Greater 84 |
230 |
Number Of Female Beneficiaries |
377 |
Number Of Male Beneficiaries |
206 |
Number Of Non Hispanic White Beneficiaries |
469 |
Number Of Black or African American Beneficiaries |
61 |
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 |
385 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
198 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
50 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
57 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.2855 |