| National Provider Identifier [NPI]: | 1780668061 |
| Last Name Of The Provider | POLASHENSKI |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 128 W 14TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HAZLETON |
| Zip Code Of The Provider | 182013266 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 2151 |
| Number Of Medicare Beneficiaries | 693 |
| Total Submitted Charge Amount | 365996 |
| Total Medicare Allowed Amount | 200478.89 |
| Total Medicare Payment Amount | 152484.27 |
| Total Medicare Standardized Payment Amount | 157590.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 109 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 1554 |
| Total Drug Medicare AllowedAmount | 613.93 |
| Total Drug Medicare PaymentAmount | 542.93 |
| Total Drug Medicare Standardized Payment Amount | 542.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 2042 |
| Number Of Medicare Beneficiaries With Medical Services | 693 |
| Total Medical Submitted Charge Amount | 364442 |
| Total Medical Medicare Allowed Amount | 199864.96 |
| Total Medical Medicare Payment Amount | 151941.34 |
| Total Medical Medicare Standardized Payment Amount | 157047.94 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 244 |
| Number Of Beneficiaries Age 75 to 84 | 207 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 414 |
| Number Of Male Beneficiaries | 279 |
| Number Of Non Hispanic White Beneficiaries | 639 |
| Number Of Black or African American Beneficiaries | |
| 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 | 516 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 177 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5374 |