| National Provider Identifier [NPI]: | 1396746541 |
| Last Name Of The Provider | JENNINGS |
| First Name Of The Provider | W |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5129 DIXIE HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402161727 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 1668 |
| Number Of Medicare Beneficiaries | 485 |
| Total Submitted Charge Amount | 113703 |
| Total Medicare Allowed Amount | 60080.56 |
| Total Medicare Payment Amount | 36654.64 |
| Total Medicare Standardized Payment Amount | 42140.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 217 |
| Number Of Medicare Beneficiaries With Drug Services | 91 |
| Total Drug Submitted ChargeAmount | 896 |
| Total Drug Medicare AllowedAmount | 443.13 |
| Total Drug Medicare PaymentAmount | 355.96 |
| Total Drug Medicare Standardized Payment Amount | 355.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 1451 |
| Number Of Medicare Beneficiaries With Medical Services | 485 |
| Total Medical Submitted Charge Amount | 112807 |
| Total Medical Medicare Allowed Amount | 59637.43 |
| Total Medical Medicare Payment Amount | 36298.68 |
| Total Medical Medicare Standardized Payment Amount | 41784.27 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 235 |
| Number Of Beneficiaries Age 75 to 84 | 164 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 280 |
| Number Of Male Beneficiaries | 205 |
| Number Of Non Hispanic White Beneficiaries | 464 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 5 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.813 |