| National Provider Identifier [NPI]: | 1801844048 |
| Last Name Of The Provider | JORDAN |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 85 BEECH ST. |
| Street Address 2 Of The Provider | HOLYOKE HOSP./RADIOLOGY |
| City Of The Provider | HOLYOKE |
| Zip Code Of The Provider | 01040 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 177 |
| Number Of Services | 34499 |
| Number Of Medicare Beneficiaries | 3123 |
| Total Submitted Charge Amount | 1587422 |
| Total Medicare Allowed Amount | 333271.06 |
| Total Medicare Payment Amount | 251289.9 |
| Total Medicare Standardized Payment Amount | 245244.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 28995 |
| Number Of Medicare Beneficiaries With Drug Services | 318 |
| Total Drug Submitted ChargeAmount | 87265 |
| Total Drug Medicare AllowedAmount | 5651.7 |
| Total Drug Medicare PaymentAmount | 4378.1 |
| Total Drug Medicare Standardized Payment Amount | 4378.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 174 |
| Number Of Medical Services | 5504 |
| Number Of Medicare Beneficiaries With Medical Services | 3123 |
| Total Medical Submitted Charge Amount | 1500157 |
| Total Medical Medicare Allowed Amount | 327619.36 |
| Total Medical Medicare Payment Amount | 246911.8 |
| Total Medical Medicare Standardized Payment Amount | 240866.56 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 583 |
| Number Of Beneficiaries Age 65 to 74 | 1057 |
| Number Of Beneficiaries Age 75 to 84 | 915 |
| Number Of Beneficiaries Age Greater 84 | 568 |
| Number Of Female Beneficiaries | 1817 |
| Number Of Male Beneficiaries | 1306 |
| Number Of Non Hispanic White Beneficiaries | 2600 |
| Number Of Black or African American Beneficiaries | 83 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 378 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2056 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1067 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4927 |