| National Provider Identifier [NPI]: | 1699746453 |
| Last Name Of The Provider | HEDLUND |
| First Name Of The Provider | JACQUELYN |
| 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 | 100 CAMPUS DRIVE |
| Street Address 2 Of The Provider | SUITE 108 |
| City Of The Provider | SCARBOROUGH |
| Zip Code Of The Provider | 040749308 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 160 |
| Number Of Services | 99854 |
| Number Of Medicare Beneficiaries | 567 |
| Total Submitted Charge Amount | 3317777.54 |
| Total Medicare Allowed Amount | 2007902.27 |
| Total Medicare Payment Amount | 1105643.83 |
| Total Medicare Standardized Payment Amount | 1106226.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 72 |
| Number Of Drug Services | 92072 |
| Number Of Medicare Beneficiaries With Drug Services | 248 |
| Total Drug Submitted ChargeAmount | 2609913.92 |
| Total Drug Medicare AllowedAmount | 1732911.73 |
| Total Drug Medicare PaymentAmount | 894041.52 |
| Total Drug Medicare Standardized Payment Amount | 894041.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 7782 |
| Number Of Medicare Beneficiaries With Medical Services | 567 |
| Total Medical Submitted Charge Amount | 707863.62 |
| Total Medical Medicare Allowed Amount | 274990.54 |
| Total Medical Medicare Payment Amount | 211602.31 |
| Total Medical Medicare Standardized Payment Amount | 212184.55 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 239 |
| Number Of Beneficiaries Age 75 to 84 | 193 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 312 |
| Number Of Male Beneficiaries | 255 |
| Number Of Non Hispanic White Beneficiaries | 549 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 462 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 105 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.7535 |