| National Provider Identifier [NPI]: | 1275647448 |
| Last Name Of The Provider | DONAHUE |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 85 POHEGANUT DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | GROTON |
| Zip Code Of The Provider | 063403216 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 786 |
| Number Of Medicare Beneficiaries | 108 |
| Total Submitted Charge Amount | 77547.02 |
| Total Medicare Allowed Amount | 50121.6 |
| Total Medicare Payment Amount | 36951.92 |
| Total Medicare Standardized Payment Amount | 36501.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1745.02 |
| Total Drug Medicare AllowedAmount | 1454.77 |
| Total Drug Medicare PaymentAmount | 1169.14 |
| Total Drug Medicare Standardized Payment Amount | 1169.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 751 |
| Number Of Medicare Beneficiaries With Medical Services | 108 |
| Total Medical Submitted Charge Amount | 75802 |
| Total Medical Medicare Allowed Amount | 48666.83 |
| Total Medical Medicare Payment Amount | 35782.78 |
| Total Medical Medicare Standardized Payment Amount | 35331.9 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 79 |
| Number Of Beneficiaries Age 75 to 84 | 17 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 108 |
| Number Of Male Beneficiaries | 0 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.7954 |