| National Provider Identifier [NPI]: | 1982649695 |
| Last Name Of The Provider | POLONE |
| First Name Of The Provider | SHANNON |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1150 N 18TH ST |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | ABILENE |
| Zip Code Of The Provider | 796012948 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 5220 |
| Number Of Medicare Beneficiaries | 424 |
| Total Submitted Charge Amount | 378538 |
| Total Medicare Allowed Amount | 145184.83 |
| Total Medicare Payment Amount | 114793.65 |
| Total Medicare Standardized Payment Amount | 136423.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 201 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 8719 |
| Total Drug Medicare AllowedAmount | 2455.51 |
| Total Drug Medicare PaymentAmount | 1952.01 |
| Total Drug Medicare Standardized Payment Amount | 1952.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 126 |
| Number Of Medical Services | 5019 |
| Number Of Medicare Beneficiaries With Medical Services | 424 |
| Total Medical Submitted Charge Amount | 369819 |
| Total Medical Medicare Allowed Amount | 142729.32 |
| Total Medical Medicare Payment Amount | 112841.64 |
| Total Medical Medicare Standardized Payment Amount | 134471.11 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 166 |
| Number Of Beneficiaries Age 75 to 84 | 170 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 255 |
| Number Of Male Beneficiaries | 169 |
| Number Of Non Hispanic White Beneficiaries | 384 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 401 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2803 |