| National Provider Identifier [NPI]: | 1770538308 |
| Last Name Of The Provider | SANSON |
| First Name Of The Provider | JODI |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1629 AIRPORT RD |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | HOT SPRINGS |
| Zip Code Of The Provider | 719137951 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 5850 |
| Number Of Medicare Beneficiaries | 864 |
| Total Submitted Charge Amount | 344938.05 |
| Total Medicare Allowed Amount | 237919.27 |
| Total Medicare Payment Amount | 176762.83 |
| Total Medicare Standardized Payment Amount | 195256.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 1431 |
| Number Of Medicare Beneficiaries With Drug Services | 294 |
| Total Drug Submitted ChargeAmount | 13867.5 |
| Total Drug Medicare AllowedAmount | 7143.71 |
| Total Drug Medicare PaymentAmount | 6665.88 |
| Total Drug Medicare Standardized Payment Amount | 6665.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 142 |
| Number Of Medical Services | 4419 |
| Number Of Medicare Beneficiaries With Medical Services | 864 |
| Total Medical Submitted Charge Amount | 331070.55 |
| Total Medical Medicare Allowed Amount | 230775.56 |
| Total Medical Medicare Payment Amount | 170096.95 |
| Total Medical Medicare Standardized Payment Amount | 188590.43 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 229 |
| Number Of Beneficiaries Age 65 to 74 | 387 |
| Number Of Beneficiaries Age 75 to 84 | 186 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 468 |
| Number Of Male Beneficiaries | 396 |
| Number Of Non Hispanic White Beneficiaries | 827 |
| Number Of Black or African American Beneficiaries | 24 |
| 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 | 662 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 202 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1618 |