| National Provider Identifier [NPI]: | 1831260256 |
| Last Name Of The Provider | CUNNINGHAM |
| First Name Of The Provider | POLLA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1005 MAR WALT DRIVE |
| Street Address 2 Of The Provider | ADMINISTRATION |
| City Of The Provider | FORT WALTON BEACH |
| Zip Code Of The Provider | 325476796 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 1071 |
| Number Of Medicare Beneficiaries | 399 |
| Total Submitted Charge Amount | 401670 |
| Total Medicare Allowed Amount | 127101.91 |
| Total Medicare Payment Amount | 99423.3 |
| Total Medicare Standardized Payment Amount | 98728.24 |
| 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 | 21 |
| Number Of Medical Services | 1071 |
| Number Of Medicare Beneficiaries With Medical Services | 399 |
| Total Medical Submitted Charge Amount | 401670 |
| Total Medical Medicare Allowed Amount | 127101.91 |
| Total Medical Medicare Payment Amount | 99423.3 |
| Total Medical Medicare Standardized Payment Amount | 98728.24 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 73 |
| Number Of Beneficiaries Age 75 to 84 | 145 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 222 |
| Number Of Male Beneficiaries | 177 |
| Number Of Non Hispanic White Beneficiaries | 372 |
| 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 | 324 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 36 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 56 |
| Percent Of With Chronic Kidney Disease | 71 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8124 |