| National Provider Identifier [NPI]: | 1851386403 |
| Last Name Of The Provider | ERNST |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | NORTH COUNTRY IMAGING CENTER |
| Street Address 2 Of The Provider | 11 MURRAY ST |
| City Of The Provider | GLENS FALLS |
| Zip Code Of The Provider | 12801 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 1808 |
| Number Of Medicare Beneficiaries | 1280 |
| Total Submitted Charge Amount | 134469 |
| Total Medicare Allowed Amount | 49928.66 |
| Total Medicare Payment Amount | 36853.99 |
| Total Medicare Standardized Payment Amount | 38642.79 |
| 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 | 113 |
| Number Of Medical Services | 1808 |
| Number Of Medicare Beneficiaries With Medical Services | 1280 |
| Total Medical Submitted Charge Amount | 134469 |
| Total Medical Medicare Allowed Amount | 49928.66 |
| Total Medical Medicare Payment Amount | 36853.99 |
| Total Medical Medicare Standardized Payment Amount | 38642.79 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 292 |
| Number Of Beneficiaries Age 65 to 74 | 450 |
| Number Of Beneficiaries Age 75 to 84 | 351 |
| Number Of Beneficiaries Age Greater 84 | 187 |
| Number Of Female Beneficiaries | 775 |
| Number Of Male Beneficiaries | 505 |
| Number Of Non Hispanic White Beneficiaries | 1239 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 870 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 410 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5739 |