| National Provider Identifier [NPI]: | 1194882241 |
| Last Name Of The Provider | POLKOWSKI |
| First Name Of The Provider | CHERYL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 880 PROSPECTOR TRL |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | HARKER HEIGHTS |
| Zip Code Of The Provider | 765482700 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 1320 |
| Number Of Medicare Beneficiaries | 172 |
| Total Submitted Charge Amount | 114871 |
| Total Medicare Allowed Amount | 85124.58 |
| Total Medicare Payment Amount | 62478.56 |
| Total Medicare Standardized Payment Amount | 66063.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 236 |
| Number Of Medicare Beneficiaries With Drug Services | 102 |
| Total Drug Submitted ChargeAmount | 12149 |
| Total Drug Medicare AllowedAmount | 6722.35 |
| Total Drug Medicare PaymentAmount | 6551.07 |
| Total Drug Medicare Standardized Payment Amount | 6551.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 1084 |
| Number Of Medicare Beneficiaries With Medical Services | 172 |
| Total Medical Submitted Charge Amount | 102722 |
| Total Medical Medicare Allowed Amount | 78402.23 |
| Total Medical Medicare Payment Amount | 55927.49 |
| Total Medical Medicare Standardized Payment Amount | 59512.76 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 96 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 104 |
| Number Of Male Beneficiaries | 68 |
| Number Of Non Hispanic White Beneficiaries | 120 |
| Number Of Black or African American Beneficiaries | 30 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0557 |