| National Provider Identifier [NPI]: | 1699707018 |
| Last Name Of The Provider | AJEMIAN |
| First Name Of The Provider | CAROLYN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 385 MAIN ST SOUTH |
| Street Address 2 Of The Provider | UNION SQUARE |
| City Of The Provider | SOUTHBURY |
| Zip Code Of The Provider | 06488 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 14945 |
| Number Of Medicare Beneficiaries | 3968 |
| Total Submitted Charge Amount | 1554608 |
| Total Medicare Allowed Amount | 441153.33 |
| Total Medicare Payment Amount | 337113.62 |
| Total Medicare Standardized Payment Amount | 312720.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 7938 |
| Number Of Medicare Beneficiaries With Drug Services | 127 |
| Total Drug Submitted ChargeAmount | 25026 |
| Total Drug Medicare AllowedAmount | 2233.37 |
| Total Drug Medicare PaymentAmount | 1607.41 |
| Total Drug Medicare Standardized Payment Amount | 1607.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 155 |
| Number Of Medical Services | 7007 |
| Number Of Medicare Beneficiaries With Medical Services | 3968 |
| Total Medical Submitted Charge Amount | 1529582 |
| Total Medical Medicare Allowed Amount | 438919.96 |
| Total Medical Medicare Payment Amount | 335506.21 |
| Total Medical Medicare Standardized Payment Amount | 311113.28 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 702 |
| Number Of Beneficiaries Age 65 to 74 | 1279 |
| Number Of Beneficiaries Age 75 to 84 | 1197 |
| Number Of Beneficiaries Age Greater 84 | 790 |
| Number Of Female Beneficiaries | 2545 |
| Number Of Male Beneficiaries | 1423 |
| Number Of Non Hispanic White Beneficiaries | 3214 |
| Number Of Black or African American Beneficiaries | 292 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 356 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 59 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2345 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1623 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6396 |