| National Provider Identifier [NPI]: | 1538190871 |
| Last Name Of The Provider | POLK |
| First Name Of The Provider | DONNA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 80 SEYMOUR STREET |
| Street Address 2 Of The Provider | HARTFORD HOSPITAL CARDIOLOGY DEPT |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061025037 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1932 |
| Number Of Medicare Beneficiaries | 1233 |
| Total Submitted Charge Amount | 313683 |
| Total Medicare Allowed Amount | 89279.4 |
| Total Medicare Payment Amount | 67324.5 |
| Total Medicare Standardized Payment Amount | 64727.79 |
| 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 | 26 |
| Number Of Medical Services | 1932 |
| Number Of Medicare Beneficiaries With Medical Services | 1233 |
| Total Medical Submitted Charge Amount | 313683 |
| Total Medical Medicare Allowed Amount | 89279.4 |
| Total Medical Medicare Payment Amount | 67324.5 |
| Total Medical Medicare Standardized Payment Amount | 64727.79 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 187 |
| Number Of Beneficiaries Age 65 to 74 | 513 |
| Number Of Beneficiaries Age 75 to 84 | 374 |
| Number Of Beneficiaries Age Greater 84 | 159 |
| Number Of Female Beneficiaries | 574 |
| Number Of Male Beneficiaries | 659 |
| Number Of Non Hispanic White Beneficiaries | 1019 |
| Number Of Black or African American Beneficiaries | 96 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 63 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 950 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 283 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.0198 |