| National Provider Identifier [NPI]: | 1750589495 |
| Last Name Of The Provider | JACUNSKI |
| First Name Of The Provider | JOANNA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 85 SEYMOUR ST |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061065501 |
| 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 | 123 |
| Number Of Services | 12267 |
| Number Of Medicare Beneficiaries | 2846 |
| Total Submitted Charge Amount | 753781 |
| Total Medicare Allowed Amount | 182198.49 |
| Total Medicare Payment Amount | 140696.69 |
| Total Medicare Standardized Payment Amount | 134248.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 7575 |
| Number Of Medicare Beneficiaries With Drug Services | 90 |
| Total Drug Submitted ChargeAmount | 22725 |
| Total Drug Medicare AllowedAmount | 1385.28 |
| Total Drug Medicare PaymentAmount | 1086.01 |
| Total Drug Medicare Standardized Payment Amount | 1086.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 122 |
| Number Of Medical Services | 4692 |
| Number Of Medicare Beneficiaries With Medical Services | 2846 |
| Total Medical Submitted Charge Amount | 731056 |
| Total Medical Medicare Allowed Amount | 180813.21 |
| Total Medical Medicare Payment Amount | 139610.68 |
| Total Medical Medicare Standardized Payment Amount | 133162.96 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 441 |
| Number Of Beneficiaries Age 65 to 74 | 1127 |
| Number Of Beneficiaries Age 75 to 84 | 860 |
| Number Of Beneficiaries Age Greater 84 | 418 |
| Number Of Female Beneficiaries | 2019 |
| Number Of Male Beneficiaries | 827 |
| Number Of Non Hispanic White Beneficiaries | 2603 |
| Number Of Black or African American Beneficiaries | 65 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 111 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2006 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 840 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2714 |