| National Provider Identifier [NPI]: | 1073501995 |
| Last Name Of The Provider | ANDREJEVA-WRIGHT |
| First Name Of The Provider | LIVA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 YORK ST |
| Street Address 2 Of The Provider | YALE NEW HAVEN HOSPITAL-SOUTH PAVILLION-2ND FL |
| City Of The Provider | NEW HAVEN |
| Zip Code Of The Provider | 065103220 |
| 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 | 84 |
| Number Of Services | 1763 |
| Number Of Medicare Beneficiaries | 860 |
| Total Submitted Charge Amount | 253506 |
| Total Medicare Allowed Amount | 55458.98 |
| Total Medicare Payment Amount | 44320.25 |
| Total Medicare Standardized Payment Amount | 41963.71 |
| 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 | 84 |
| Number Of Medical Services | 1763 |
| Number Of Medicare Beneficiaries With Medical Services | 860 |
| Total Medical Submitted Charge Amount | 253506 |
| Total Medical Medicare Allowed Amount | 55458.98 |
| Total Medical Medicare Payment Amount | 44320.25 |
| Total Medical Medicare Standardized Payment Amount | 41963.71 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 198 |
| Number Of Beneficiaries Age 65 to 74 | 326 |
| Number Of Beneficiaries Age 75 to 84 | 194 |
| Number Of Beneficiaries Age Greater 84 | 142 |
| Number Of Female Beneficiaries | 655 |
| Number Of Male Beneficiaries | 205 |
| Number Of Non Hispanic White Beneficiaries | 599 |
| Number Of Black or African American Beneficiaries | 158 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 73 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 537 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 323 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.834 |