| National Provider Identifier [NPI]: | 1740281500 |
| Last Name Of The Provider | JENSEN |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7396 UNION PARK AVE |
| Street Address 2 Of The Provider | 201 |
| City Of The Provider | MIDVALE |
| Zip Code Of The Provider | 840476700 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 5126 |
| Number Of Medicare Beneficiaries | 760 |
| Total Submitted Charge Amount | 475931 |
| Total Medicare Allowed Amount | 275419.35 |
| Total Medicare Payment Amount | 192581.04 |
| Total Medicare Standardized Payment Amount | 199834.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 2811 |
| Total Drug Medicare AllowedAmount | 2244.42 |
| Total Drug Medicare PaymentAmount | 1569.86 |
| Total Drug Medicare Standardized Payment Amount | 1569.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 5093 |
| Number Of Medicare Beneficiaries With Medical Services | 760 |
| Total Medical Submitted Charge Amount | 473120 |
| Total Medical Medicare Allowed Amount | 273174.93 |
| Total Medical Medicare Payment Amount | 191011.18 |
| Total Medical Medicare Standardized Payment Amount | 198264.41 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 384 |
| Number Of Beneficiaries Age 75 to 84 | 274 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 365 |
| Number Of Male Beneficiaries | 395 |
| Number Of Non Hispanic White Beneficiaries | 744 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8216 |