| National Provider Identifier [NPI]: | 1922298470 |
| Last Name Of The Provider | FAIRFIELD |
| First Name Of The Provider | JAIME |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 CAMPUS DR |
| Street Address 2 Of The Provider | SUITE 108 |
| City Of The Provider | SCARBOROUGH |
| Zip Code Of The Provider | 040747171 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 6954 |
| Number Of Medicare Beneficiaries | 170 |
| Total Submitted Charge Amount | 216411.06 |
| Total Medicare Allowed Amount | 107482.67 |
| Total Medicare Payment Amount | 84737.7 |
| Total Medicare Standardized Payment Amount | 88571.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 40 |
| Number Of Drug Services | 5866 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 109690.97 |
| Total Drug Medicare AllowedAmount | 71257.74 |
| Total Drug Medicare PaymentAmount | 55827.22 |
| Total Drug Medicare Standardized Payment Amount | 55827.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 1088 |
| Number Of Medicare Beneficiaries With Medical Services | 170 |
| Total Medical Submitted Charge Amount | 106720.09 |
| Total Medical Medicare Allowed Amount | 36224.93 |
| Total Medical Medicare Payment Amount | 28910.48 |
| Total Medical Medicare Standardized Payment Amount | 32743.97 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 70 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 85 |
| Number Of Male Beneficiaries | 85 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 136 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 38 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.1931 |