| National Provider Identifier [NPI]: | 1083702070 |
| Last Name Of The Provider | POLISE |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | D.O |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 640 S STATE STREET |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY |
| City Of The Provider | DOVER |
| Zip Code Of The Provider | 199013530 |
| State Code Of The Provider | DE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 205 |
| Number Of Services | 12560 |
| Number Of Medicare Beneficiaries | 6552 |
| Total Submitted Charge Amount | 1830892 |
| Total Medicare Allowed Amount | 430152.19 |
| Total Medicare Payment Amount | 326011.94 |
| Total Medicare Standardized Payment Amount | 325113.2 |
| 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 | 205 |
| Number Of Medical Services | 12560 |
| Number Of Medicare Beneficiaries With Medical Services | 6552 |
| Total Medical Submitted Charge Amount | 1830892 |
| Total Medical Medicare Allowed Amount | 430152.19 |
| Total Medical Medicare Payment Amount | 326011.94 |
| Total Medical Medicare Standardized Payment Amount | 325113.2 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 1058 |
| Number Of Beneficiaries Age 65 to 74 | 2591 |
| Number Of Beneficiaries Age 75 to 84 | 2019 |
| Number Of Beneficiaries Age Greater 84 | 884 |
| Number Of Female Beneficiaries | 4000 |
| Number Of Male Beneficiaries | 2552 |
| Number Of Non Hispanic White Beneficiaries | 5006 |
| Number Of Black or African American Beneficiaries | 1281 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 140 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 71 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5084 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1468 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6193 |