| National Provider Identifier [NPI]: | 1104853787 |
| Last Name Of The Provider | JAIN |
| First Name Of The Provider | AJAY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1497 FAIR RD |
| Street Address 2 Of The Provider | SUITE 305 |
| City Of The Provider | STATESBORO |
| Zip Code Of The Provider | 304580822 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 24440 |
| Number Of Medicare Beneficiaries | 1865 |
| Total Submitted Charge Amount | 3411524.06 |
| Total Medicare Allowed Amount | 1343137.2 |
| Total Medicare Payment Amount | 1025320.55 |
| Total Medicare Standardized Payment Amount | 1055719.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 13171 |
| Number Of Medicare Beneficiaries With Drug Services | 445 |
| Total Drug Submitted ChargeAmount | 64653.54 |
| Total Drug Medicare AllowedAmount | 37171.29 |
| Total Drug Medicare PaymentAmount | 28810.43 |
| Total Drug Medicare Standardized Payment Amount | 28810.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 11269 |
| Number Of Medicare Beneficiaries With Medical Services | 1865 |
| Total Medical Submitted Charge Amount | 3346870.52 |
| Total Medical Medicare Allowed Amount | 1305965.91 |
| Total Medical Medicare Payment Amount | 996510.12 |
| Total Medical Medicare Standardized Payment Amount | 1026908.93 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 410 |
| Number Of Beneficiaries Age 65 to 74 | 710 |
| Number Of Beneficiaries Age 75 to 84 | 523 |
| Number Of Beneficiaries Age Greater 84 | 222 |
| Number Of Female Beneficiaries | 1072 |
| Number Of Male Beneficiaries | 793 |
| Number Of Non Hispanic White Beneficiaries | 1206 |
| Number Of Black or African American Beneficiaries | 631 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| 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 | 1114 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 751 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.674 |