| National Provider Identifier [NPI]: | 1871524132 |
| Last Name Of The Provider | OWENSBY |
| First Name Of The Provider | JERRY |
| 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 | 6242 E ARBOR AVE |
| Street Address 2 Of The Provider | SUITE 111 |
| City Of The Provider | MESA |
| Zip Code Of The Provider | 852061309 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 16166 |
| Number Of Medicare Beneficiaries | 2140 |
| Total Submitted Charge Amount | 1137612 |
| Total Medicare Allowed Amount | 710684.92 |
| Total Medicare Payment Amount | 514040.23 |
| Total Medicare Standardized Payment Amount | 517941.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 6454 |
| Number Of Medicare Beneficiaries With Drug Services | 466 |
| Total Drug Submitted ChargeAmount | 141760 |
| Total Drug Medicare AllowedAmount | 95174.14 |
| Total Drug Medicare PaymentAmount | 76031.17 |
| Total Drug Medicare Standardized Payment Amount | 76031.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 9712 |
| Number Of Medicare Beneficiaries With Medical Services | 2140 |
| Total Medical Submitted Charge Amount | 995852 |
| Total Medical Medicare Allowed Amount | 615510.78 |
| Total Medical Medicare Payment Amount | 438009.06 |
| Total Medical Medicare Standardized Payment Amount | 441910.53 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 836 |
| Number Of Beneficiaries Age 75 to 84 | 846 |
| Number Of Beneficiaries Age Greater 84 | 423 |
| Number Of Female Beneficiaries | 1604 |
| Number Of Male Beneficiaries | 536 |
| Number Of Non Hispanic White Beneficiaries | 2056 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0253 |