| National Provider Identifier [NPI]: | 1740374826 |
| Last Name Of The Provider | RICHARDSON |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3404 NEWTON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | JASPER |
| Zip Code Of The Provider | 475461020 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 2076 |
| Number Of Medicare Beneficiaries | 451 |
| Total Submitted Charge Amount | 167114.25 |
| Total Medicare Allowed Amount | 114232.41 |
| Total Medicare Payment Amount | 76856.47 |
| Total Medicare Standardized Payment Amount | 83648.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 381 |
| Number Of Medicare Beneficiaries With Drug Services | 148 |
| Total Drug Submitted ChargeAmount | 8805 |
| Total Drug Medicare AllowedAmount | 1613.8 |
| Total Drug Medicare PaymentAmount | 1255.19 |
| Total Drug Medicare Standardized Payment Amount | 1255.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 1695 |
| Number Of Medicare Beneficiaries With Medical Services | 451 |
| Total Medical Submitted Charge Amount | 158309.25 |
| Total Medical Medicare Allowed Amount | 112618.61 |
| Total Medical Medicare Payment Amount | 75601.28 |
| Total Medical Medicare Standardized Payment Amount | 82393 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 185 |
| Number Of Beneficiaries Age 75 to 84 | 139 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 319 |
| Number Of Male Beneficiaries | 132 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 368 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.019 |