| National Provider Identifier [NPI]: | 1568459048 |
| Last Name Of The Provider | POLANCO |
| First Name Of The Provider | ROBERTO |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11760 SW 40TH ST |
| Street Address 2 Of The Provider | 416 |
| City Of The Provider | MIAMI |
| Zip Code Of The Provider | 331753582 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 1018 |
| Number Of Medicare Beneficiaries | 194 |
| Total Submitted Charge Amount | 160765 |
| Total Medicare Allowed Amount | 93239.11 |
| Total Medicare Payment Amount | 71634.85 |
| Total Medicare Standardized Payment Amount | 66265.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 55 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 550 |
| Total Drug Medicare AllowedAmount | 97.87 |
| Total Drug Medicare PaymentAmount | 76.7 |
| Total Drug Medicare Standardized Payment Amount | 76.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 963 |
| Number Of Medicare Beneficiaries With Medical Services | 194 |
| Total Medical Submitted Charge Amount | 160215 |
| Total Medical Medicare Allowed Amount | 93141.24 |
| Total Medical Medicare Payment Amount | 71558.15 |
| Total Medical Medicare Standardized Payment Amount | 66188.46 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 56 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 141 |
| Number Of Male Beneficiaries | 53 |
| Number Of Non Hispanic White Beneficiaries | 25 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 157 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 42 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 152 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 46 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 68 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 31 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 20 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.699 |