| National Provider Identifier [NPI]: | 1811975162 |
| Last Name Of The Provider | JENKINS-HAYNIE |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17452 RICHMOND ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CALLAO |
| Zip Code Of The Provider | 22435 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 130 |
| Number Of Services | 6405 |
| Number Of Medicare Beneficiaries | 500 |
| Total Submitted Charge Amount | 330898 |
| Total Medicare Allowed Amount | 199256.34 |
| Total Medicare Payment Amount | 151664.99 |
| Total Medicare Standardized Payment Amount | 154741 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 345 |
| Number Of Medicare Beneficiaries With Drug Services | 165 |
| Total Drug Submitted ChargeAmount | 9875 |
| Total Drug Medicare AllowedAmount | 4961.33 |
| Total Drug Medicare PaymentAmount | 4673.88 |
| Total Drug Medicare Standardized Payment Amount | 4673.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 6060 |
| Number Of Medicare Beneficiaries With Medical Services | 500 |
| Total Medical Submitted Charge Amount | 321023 |
| Total Medical Medicare Allowed Amount | 194295.01 |
| Total Medical Medicare Payment Amount | 146991.11 |
| Total Medical Medicare Standardized Payment Amount | 150067.12 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 68 |
| Number Of Beneficiaries Age 65 to 74 | 214 |
| Number Of Beneficiaries Age 75 to 84 | 145 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 287 |
| Number Of Male Beneficiaries | 213 |
| Number Of Non Hispanic White Beneficiaries | 352 |
| 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 | 404 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0704 |