| National Provider Identifier [NPI]: | 1366471013 |
| Last Name Of The Provider | QUIRAM |
| First Name Of The Provider | POLLY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7760 FRANCE AVE S |
| Street Address 2 Of The Provider | SUITE 310 |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554355800 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 14680 |
| Number Of Medicare Beneficiaries | 1046 |
| Total Submitted Charge Amount | 3102723.64 |
| Total Medicare Allowed Amount | 2724135.44 |
| Total Medicare Payment Amount | 2107909.79 |
| Total Medicare Standardized Payment Amount | 2105622.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 6387 |
| Number Of Medicare Beneficiaries With Drug Services | 596 |
| Total Drug Submitted ChargeAmount | 2231271.96 |
| Total Drug Medicare AllowedAmount | 1901378.88 |
| Total Drug Medicare PaymentAmount | 1490429.49 |
| Total Drug Medicare Standardized Payment Amount | 1490429.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 8293 |
| Number Of Medicare Beneficiaries With Medical Services | 1046 |
| Total Medical Submitted Charge Amount | 871451.68 |
| Total Medical Medicare Allowed Amount | 822756.56 |
| Total Medical Medicare Payment Amount | 617480.3 |
| Total Medical Medicare Standardized Payment Amount | 615193.01 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 92 |
| Number Of Beneficiaries Age 65 to 74 | 264 |
| Number Of Beneficiaries Age 75 to 84 | 348 |
| Number Of Beneficiaries Age Greater 84 | 342 |
| Number Of Female Beneficiaries | 640 |
| Number Of Male Beneficiaries | 406 |
| Number Of Non Hispanic White Beneficiaries | 979 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 912 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 134 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4063 |