| National Provider Identifier [NPI]: | 1033227947 |
| Last Name Of The Provider | JENSEN |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1215 PLEASANT ST |
| Street Address 2 Of The Provider | STE 206 |
| City Of The Provider | DES MOINES |
| Zip Code Of The Provider | 503091416 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 5758 |
| Number Of Medicare Beneficiaries | 440 |
| Total Submitted Charge Amount | 357531.05 |
| Total Medicare Allowed Amount | 171494.22 |
| Total Medicare Payment Amount | 134534.22 |
| Total Medicare Standardized Payment Amount | 143304.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 306 |
| Number Of Medicare Beneficiaries With Drug Services | 113 |
| Total Drug Submitted ChargeAmount | 5730.5 |
| Total Drug Medicare AllowedAmount | 2940.72 |
| Total Drug Medicare PaymentAmount | 2795.94 |
| Total Drug Medicare Standardized Payment Amount | 2795.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 5452 |
| Number Of Medicare Beneficiaries With Medical Services | 440 |
| Total Medical Submitted Charge Amount | 351800.55 |
| Total Medical Medicare Allowed Amount | 168553.5 |
| Total Medical Medicare Payment Amount | 131738.28 |
| Total Medical Medicare Standardized Payment Amount | 140508.8 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 119 |
| Number Of Beneficiaries Age Greater 84 | 88 |
| Number Of Female Beneficiaries | 337 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 417 |
| Number Of Black or African American Beneficiaries | 11 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 394 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3227 |