| National Provider Identifier [NPI]: | 1679541619 |
| Last Name Of The Provider | AHN |
| First Name Of The Provider | JAE |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | ST. BARNABAS HOSPITAL |
| Street Address 2 Of The Provider | 183RD STREET AND THIRD AVE. |
| City Of The Provider | BRONX |
| Zip Code Of The Provider | 10457 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 243 |
| Number Of Medicare Beneficiaries | 107 |
| Total Submitted Charge Amount | 39394.04 |
| Total Medicare Allowed Amount | 21928.06 |
| Total Medicare Payment Amount | 15919.1 |
| Total Medicare Standardized Payment Amount | 13703.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 16 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 455 |
| Total Drug Medicare AllowedAmount | 77.97 |
| Total Drug Medicare PaymentAmount | 67.52 |
| Total Drug Medicare Standardized Payment Amount | 67.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 227 |
| Number Of Medicare Beneficiaries With Medical Services | 107 |
| Total Medical Submitted Charge Amount | 38939.04 |
| Total Medical Medicare Allowed Amount | 21850.09 |
| Total Medical Medicare Payment Amount | 15851.58 |
| Total Medical Medicare Standardized Payment Amount | 13635.81 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 36 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 64 |
| Number Of Male Beneficiaries | 43 |
| Number Of Non Hispanic White Beneficiaries | 43 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 53 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0433 |