| National Provider Identifier [NPI]: | 1245222744 |
| Last Name Of The Provider | YOUNG |
| First Name Of The Provider | POLLY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3100 TELEGRAPH AVE |
| Street Address 2 Of The Provider | #2109 EAST BAY FAMILY PRACTICE MEDICAL GROUP INC |
| City Of The Provider | OAKLAND |
| Zip Code Of The Provider | 946093210 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 339 |
| Number Of Medicare Beneficiaries | 115 |
| Total Submitted Charge Amount | 64575 |
| Total Medicare Allowed Amount | 28206.7 |
| Total Medicare Payment Amount | 22917.01 |
| Total Medicare Standardized Payment Amount | 20474.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 9796 |
| Total Drug Medicare AllowedAmount | 4091.71 |
| Total Drug Medicare PaymentAmount | 4009.76 |
| Total Drug Medicare Standardized Payment Amount | 4009.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 282 |
| Number Of Medicare Beneficiaries With Medical Services | 115 |
| Total Medical Submitted Charge Amount | 54779 |
| Total Medical Medicare Allowed Amount | 24114.99 |
| Total Medical Medicare Payment Amount | 18907.25 |
| Total Medical Medicare Standardized Payment Amount | 16464.62 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 87 |
| Number Of Beneficiaries Age 75 to 84 | 13 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 90 |
| Number Of Male Beneficiaries | 25 |
| Number Of Non Hispanic White Beneficiaries | 90 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 101 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 18 |
| Percent Of With Hypertension | 23 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.7313 |