| National Provider Identifier [NPI]: | 1366418121 |
| Last Name Of The Provider | BENNETT |
| First Name Of The Provider | JOANN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1100 E 21ST ST |
| Street Address 2 Of The Provider | STE 601 |
| City Of The Provider | SIOUX FALLS |
| Zip Code Of The Provider | 571051020 |
| State Code Of The Provider | SD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 236 |
| Number Of Medicare Beneficiaries | 133 |
| Total Submitted Charge Amount | 62338 |
| Total Medicare Allowed Amount | 33313.78 |
| Total Medicare Payment Amount | 26118.07 |
| Total Medicare Standardized Payment Amount | 24566.37 |
| 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 | 12 |
| Number Of Medical Services | 236 |
| Number Of Medicare Beneficiaries With Medical Services | 133 |
| Total Medical Submitted Charge Amount | 62338 |
| Total Medical Medicare Allowed Amount | 33313.78 |
| Total Medical Medicare Payment Amount | 26118.07 |
| Total Medical Medicare Standardized Payment Amount | 24566.37 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 44 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 71 |
| Number Of Male Beneficiaries | 62 |
| Number Of Non Hispanic White Beneficiaries | 120 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 111 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 39 |
| Percent Of With Alzheimers Disease or Dementia | 55 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 66 |
| Percent Of With Chronic Kidney Disease | 74 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 58 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 3.3249 |