| National Provider Identifier [NPI]: | 1194766253 |
| Last Name Of The Provider | JENNINGS |
| First Name Of The Provider | SHAUN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8726 US HIGHWAY 42 |
| Street Address 2 Of The Provider | |
| City Of The Provider | FLORENCE |
| Zip Code Of The Provider | 410429625 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 2650 |
| Number Of Medicare Beneficiaries | 449 |
| Total Submitted Charge Amount | 249313 |
| Total Medicare Allowed Amount | 147538.28 |
| Total Medicare Payment Amount | 103570.61 |
| Total Medicare Standardized Payment Amount | 111902.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 187 |
| Number Of Medicare Beneficiaries With Drug Services | 149 |
| Total Drug Submitted ChargeAmount | 8659 |
| Total Drug Medicare AllowedAmount | 5437.4 |
| Total Drug Medicare PaymentAmount | 5224.46 |
| Total Drug Medicare Standardized Payment Amount | 5224.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 2463 |
| Number Of Medicare Beneficiaries With Medical Services | 449 |
| Total Medical Submitted Charge Amount | 240654 |
| Total Medical Medicare Allowed Amount | 142100.88 |
| Total Medical Medicare Payment Amount | 98346.15 |
| Total Medical Medicare Standardized Payment Amount | 106677.94 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 160 |
| Number Of Beneficiaries Age 75 to 84 | 138 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 262 |
| Number Of Male Beneficiaries | 187 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 382 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5433 |