| National Provider Identifier [NPI]: | 1669406773 |
| Last Name Of The Provider | SIVAK |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2500 METROHEALTH DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLEVELAND |
| Zip Code Of The Provider | 441091900 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 1194 |
| Number Of Medicare Beneficiaries | 537 |
| Total Submitted Charge Amount | 196668 |
| Total Medicare Allowed Amount | 40419.97 |
| Total Medicare Payment Amount | 28806.91 |
| Total Medicare Standardized Payment Amount | 29522.46 |
| 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 | 30 |
| Number Of Medical Services | 1194 |
| Number Of Medicare Beneficiaries With Medical Services | 537 |
| Total Medical Submitted Charge Amount | 196668 |
| Total Medical Medicare Allowed Amount | 40419.97 |
| Total Medical Medicare Payment Amount | 28806.91 |
| Total Medical Medicare Standardized Payment Amount | 29522.46 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 280 |
| Number Of Beneficiaries Age 65 to 74 | 186 |
| Number Of Beneficiaries Age 75 to 84 | 58 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 317 |
| Number Of Male Beneficiaries | 220 |
| Number Of Non Hispanic White Beneficiaries | 289 |
| Number Of Black or African American Beneficiaries | 186 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 199 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 338 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 31 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 54 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.6237 |