| National Provider Identifier [NPI]: | 1750427688 |
| Last Name Of The Provider | HAMNER |
| First Name Of The Provider | JEWELL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD,MBA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1013 MEDICAL CENTER PKWY |
| Street Address 2 Of The Provider | FRIST - HOWELL BUILDING II |
| City Of The Provider | SELMA |
| Zip Code Of The Provider | 367016742 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 2078 |
| Number Of Medicare Beneficiaries | 740 |
| Total Submitted Charge Amount | 270321.78 |
| Total Medicare Allowed Amount | 124902.61 |
| Total Medicare Payment Amount | 95771.89 |
| Total Medicare Standardized Payment Amount | 102248.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 115 |
| Number Of Medicare Beneficiaries With Drug Services | 88 |
| Total Drug Submitted ChargeAmount | 3140.03 |
| Total Drug Medicare AllowedAmount | 2031.46 |
| Total Drug Medicare PaymentAmount | 1983.54 |
| Total Drug Medicare Standardized Payment Amount | 1983.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1963 |
| Number Of Medicare Beneficiaries With Medical Services | 740 |
| Total Medical Submitted Charge Amount | 267181.75 |
| Total Medical Medicare Allowed Amount | 122871.15 |
| Total Medical Medicare Payment Amount | 93788.35 |
| Total Medical Medicare Standardized Payment Amount | 100264.93 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 212 |
| Number Of Beneficiaries Age 65 to 74 | 256 |
| Number Of Beneficiaries Age 75 to 84 | 171 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 445 |
| Number Of Male Beneficiaries | 295 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 582 |
| 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 | 310 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 430 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8132 |