| National Provider Identifier [NPI]: | 1073510087 |
| Last Name Of The Provider | SAGALOVSKY |
| First Name Of The Provider | BORIS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1205 S MAIN ST |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | CROWN POINT |
| Zip Code Of The Provider | 463073677 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 104 |
| Number Of Services | 6919 |
| Number Of Medicare Beneficiaries | 2218 |
| Total Submitted Charge Amount | 2125202 |
| Total Medicare Allowed Amount | 568862.98 |
| Total Medicare Payment Amount | 419489.32 |
| Total Medicare Standardized Payment Amount | 418718.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 308 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 23100 |
| Total Drug Medicare AllowedAmount | 16311.21 |
| Total Drug Medicare PaymentAmount | 12663.24 |
| Total Drug Medicare Standardized Payment Amount | 12663.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 103 |
| Number Of Medical Services | 6611 |
| Number Of Medicare Beneficiaries With Medical Services | 2218 |
| Total Medical Submitted Charge Amount | 2102102 |
| Total Medical Medicare Allowed Amount | 552551.77 |
| Total Medical Medicare Payment Amount | 406826.08 |
| Total Medical Medicare Standardized Payment Amount | 406055.55 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 204 |
| Number Of Beneficiaries Age 65 to 74 | 823 |
| Number Of Beneficiaries Age 75 to 84 | 731 |
| Number Of Beneficiaries Age Greater 84 | 460 |
| Number Of Female Beneficiaries | 1209 |
| Number Of Male Beneficiaries | 1009 |
| Number Of Non Hispanic White Beneficiaries | 2088 |
| Number Of Black or African American Beneficiaries | 45 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 64 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1928 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 290 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.4816 |