| National Provider Identifier [NPI]: | 1225028525 |
| Last Name Of The Provider | STODDARD |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 293 OLMSTED BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PINEHURST |
| Zip Code Of The Provider | 283749023 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 5016 |
| Number Of Medicare Beneficiaries | 809 |
| Total Submitted Charge Amount | 1180599 |
| Total Medicare Allowed Amount | 442514.92 |
| Total Medicare Payment Amount | 340442.95 |
| Total Medicare Standardized Payment Amount | 353466.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1482 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 29640 |
| Total Drug Medicare AllowedAmount | 16926.98 |
| Total Drug Medicare PaymentAmount | 12504.43 |
| Total Drug Medicare Standardized Payment Amount | 12504.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 3534 |
| Number Of Medicare Beneficiaries With Medical Services | 809 |
| Total Medical Submitted Charge Amount | 1150959 |
| Total Medical Medicare Allowed Amount | 425587.94 |
| Total Medical Medicare Payment Amount | 327938.52 |
| Total Medical Medicare Standardized Payment Amount | 340962.18 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 255 |
| Number Of Beneficiaries Age 65 to 74 | 261 |
| Number Of Beneficiaries Age 75 to 84 | 220 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 422 |
| Number Of Male Beneficiaries | 387 |
| Number Of Non Hispanic White Beneficiaries | 413 |
| Number Of Black or African American Beneficiaries | 358 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 16 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 498 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 311 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 4.9847 |