| National Provider Identifier [NPI]: | 1477593002 |
| Last Name Of The Provider | JENNINGS |
| First Name Of The Provider | REX |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3560 DELAWARE STREET, |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEAUMONT |
| Zip Code Of The Provider | 77706 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 4317 |
| Number Of Medicare Beneficiaries | 2199 |
| Total Submitted Charge Amount | 712386.45 |
| Total Medicare Allowed Amount | 155955.19 |
| Total Medicare Payment Amount | 117166.54 |
| Total Medicare Standardized Payment Amount | 120954.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 178 |
| Number Of Medical Services | 4317 |
| Number Of Medicare Beneficiaries With Medical Services | 2199 |
| Total Medical Submitted Charge Amount | 712386.45 |
| Total Medical Medicare Allowed Amount | 155955.19 |
| Total Medical Medicare Payment Amount | 117166.54 |
| Total Medical Medicare Standardized Payment Amount | 120954.84 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 369 |
| Number Of Beneficiaries Age 65 to 74 | 753 |
| Number Of Beneficiaries Age 75 to 84 | 678 |
| Number Of Beneficiaries Age Greater 84 | 399 |
| Number Of Female Beneficiaries | 1349 |
| Number Of Male Beneficiaries | 850 |
| Number Of Non Hispanic White Beneficiaries | 2157 |
| 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 | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1637 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 562 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5155 |