| National Provider Identifier [NPI]: | 1447221890 |
| Last Name Of The Provider | HAGENSCHNEIDER |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 989 MEDICAL PARK DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MAYSVILLE |
| Zip Code Of The Provider | 410568750 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 183 |
| Number Of Services | 5554 |
| Number Of Medicare Beneficiaries | 2654 |
| Total Submitted Charge Amount | 481878 |
| Total Medicare Allowed Amount | 145961.02 |
| Total Medicare Payment Amount | 112292.97 |
| Total Medicare Standardized Payment Amount | 119146.09 |
| 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 | 183 |
| Number Of Medical Services | 5554 |
| Number Of Medicare Beneficiaries With Medical Services | 2654 |
| Total Medical Submitted Charge Amount | 481878 |
| Total Medical Medicare Allowed Amount | 145961.02 |
| Total Medical Medicare Payment Amount | 112292.97 |
| Total Medical Medicare Standardized Payment Amount | 119146.09 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 612 |
| Number Of Beneficiaries Age 65 to 74 | 1027 |
| Number Of Beneficiaries Age 75 to 84 | 689 |
| Number Of Beneficiaries Age Greater 84 | 326 |
| Number Of Female Beneficiaries | 1659 |
| Number Of Male Beneficiaries | 995 |
| Number Of Non Hispanic White Beneficiaries | 2555 |
| Number Of Black or African American Beneficiaries | 74 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1630 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1024 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4719 |