National Provider Identifier [NPI]: |
1265400709 |
Last Name Of The Provider |
POLSKY |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1309 N FLAGLER DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST PALM BEACH |
Zip Code Of The Provider |
334013406 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
140 |
Number Of Medicare Beneficiaries |
119 |
Total Submitted Charge Amount |
194746 |
Total Medicare Allowed Amount |
21922.96 |
Total Medicare Payment Amount |
17150.08 |
Total Medicare Standardized Payment Amount |
16270.58 |
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 |
18 |
Number Of Medical Services |
140 |
Number Of Medicare Beneficiaries With Medical Services |
119 |
Total Medical Submitted Charge Amount |
194746 |
Total Medical Medicare Allowed Amount |
21922.96 |
Total Medical Medicare Payment Amount |
17150.08 |
Total Medical Medicare Standardized Payment Amount |
16270.58 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
35 |
Number Of Beneficiaries Age 75 to 84 |
23 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
62 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
80 |
Number Of Black or African American Beneficiaries |
28 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
73 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
46 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.103 |