| National Provider Identifier [NPI]: | 1790939155 |
| Last Name Of The Provider | HAGN |
| First Name Of The Provider | EMILY |
| 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 | 30 N 1900 E |
| Street Address 2 Of The Provider | ROOM 3C444 |
| City Of The Provider | SALT LAKE CITY |
| Zip Code Of The Provider | 841320002 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 439 |
| Number Of Medicare Beneficiaries | 175 |
| Total Submitted Charge Amount | 291571.78 |
| Total Medicare Allowed Amount | 59128.67 |
| Total Medicare Payment Amount | 45014.72 |
| Total Medicare Standardized Payment Amount | 45140.25 |
| 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 | 87 |
| Number Of Medical Services | 439 |
| Number Of Medicare Beneficiaries With Medical Services | 175 |
| Total Medical Submitted Charge Amount | 291571.78 |
| Total Medical Medicare Allowed Amount | 59128.67 |
| Total Medical Medicare Payment Amount | 45014.72 |
| Total Medical Medicare Standardized Payment Amount | 45140.25 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 68 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 89 |
| Number Of Male Beneficiaries | 86 |
| Number Of Non Hispanic White Beneficiaries | 149 |
| 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 | 129 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4259 |