| National Provider Identifier [NPI]: | 1043487911 |
| Last Name Of The Provider | POLASEK |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 BAYLOR PLZ |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770303411 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 221 |
| Number Of Services | 5092 |
| Number Of Medicare Beneficiaries | 3597 |
| Total Submitted Charge Amount | 1284344 |
| Total Medicare Allowed Amount | 229174.26 |
| Total Medicare Payment Amount | 176407.2 |
| Total Medicare Standardized Payment Amount | 178658.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 221 |
| Number Of Medical Services | 5092 |
| Number Of Medicare Beneficiaries With Medical Services | 3597 |
| Total Medical Submitted Charge Amount | 1284344 |
| Total Medical Medicare Allowed Amount | 229174.26 |
| Total Medical Medicare Payment Amount | 176407.2 |
| Total Medical Medicare Standardized Payment Amount | 178658.81 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 590 |
| Number Of Beneficiaries Age 65 to 74 | 1303 |
| Number Of Beneficiaries Age 75 to 84 | 1072 |
| Number Of Beneficiaries Age Greater 84 | 632 |
| Number Of Female Beneficiaries | 2067 |
| Number Of Male Beneficiaries | 1530 |
| Number Of Non Hispanic White Beneficiaries | 2338 |
| Number Of Black or African American Beneficiaries | 677 |
| Number Of AsianPacific Islander Beneficiaries | 153 |
| Number Of Hispanic Beneficiaries | 387 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2856 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 741 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 23 |
| Average HCC Risk Score Of Beneficiaries | 2.3014 |