National Provider Identifier [NPI]: |
1336112119 |
Last Name Of The Provider |
POLOWY |
First Name Of The Provider |
CLAYTON |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1432 S DOBSON RD |
Street Address 2 Of The Provider |
106 |
City Of The Provider |
MESA |
Zip Code Of The Provider |
852024769 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Medical Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
126 |
Number Of Services |
174724 |
Number Of Medicare Beneficiaries |
649 |
Total Submitted Charge Amount |
4460040 |
Total Medicare Allowed Amount |
2233506.27 |
Total Medicare Payment Amount |
1717652.04 |
Total Medicare Standardized Payment Amount |
1719653.09 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
70 |
Number Of Drug Services |
170107 |
Number Of Medicare Beneficiaries With Drug Services |
220 |
Total Drug Submitted ChargeAmount |
3470745 |
Total Drug Medicare AllowedAmount |
1753033.19 |
Total Drug Medicare PaymentAmount |
1354762.7 |
Total Drug Medicare Standardized Payment Amount |
1354762.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
4617 |
Number Of Medicare Beneficiaries With Medical Services |
648 |
Total Medical Submitted Charge Amount |
989295 |
Total Medical Medicare Allowed Amount |
480473.08 |
Total Medical Medicare Payment Amount |
362889.34 |
Total Medical Medicare Standardized Payment Amount |
364890.39 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
350 |
Number Of Beneficiaries Age 75 to 84 |
183 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
399 |
Number Of Male Beneficiaries |
250 |
Number Of Non Hispanic White Beneficiaries |
556 |
Number Of Black or African American Beneficiaries |
24 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
45 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
611 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
50 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6632 |