| National Provider Identifier [NPI]: | 1104845940 |
| Last Name Of The Provider | GOLJA |
| First Name Of The Provider | ANNA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 LONGWOOD AVE |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY, 2ND FLOOR, MAIN BLDG |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021155724 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 1769 |
| Number Of Medicare Beneficiaries | 1183 |
| Total Submitted Charge Amount | 213486 |
| Total Medicare Allowed Amount | 45969.64 |
| Total Medicare Payment Amount | 35737.18 |
| Total Medicare Standardized Payment Amount | 34683.33 |
| 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 | 118 |
| Number Of Medical Services | 1769 |
| Number Of Medicare Beneficiaries With Medical Services | 1183 |
| Total Medical Submitted Charge Amount | 213486 |
| Total Medical Medicare Allowed Amount | 45969.64 |
| Total Medical Medicare Payment Amount | 35737.18 |
| Total Medical Medicare Standardized Payment Amount | 34683.33 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 229 |
| Number Of Beneficiaries Age 65 to 74 | 342 |
| Number Of Beneficiaries Age 75 to 84 | 323 |
| Number Of Beneficiaries Age Greater 84 | 289 |
| Number Of Female Beneficiaries | 786 |
| Number Of Male Beneficiaries | 397 |
| Number Of Non Hispanic White Beneficiaries | 1025 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 70 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 817 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 366 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6916 |