| National Provider Identifier [NPI]: | 1285623090 |
| Last Name Of The Provider | JENNINGS |
| First Name Of The Provider | LARI |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1125 E SOUTHERN AVE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | MESA |
| Zip Code Of The Provider | 852045045 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 3557 |
| Number Of Medicare Beneficiaries | 1583 |
| Total Submitted Charge Amount | 642293.3 |
| Total Medicare Allowed Amount | 265134.73 |
| Total Medicare Payment Amount | 230086.22 |
| Total Medicare Standardized Payment Amount | 232670.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 341 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 1881.3 |
| Total Drug Medicare AllowedAmount | 673.61 |
| Total Drug Medicare PaymentAmount | 528.16 |
| Total Drug Medicare Standardized Payment Amount | 528.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 3216 |
| Number Of Medicare Beneficiaries With Medical Services | 1583 |
| Total Medical Submitted Charge Amount | 640412 |
| Total Medical Medicare Allowed Amount | 264461.12 |
| Total Medical Medicare Payment Amount | 229558.06 |
| Total Medical Medicare Standardized Payment Amount | 232142.62 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 992 |
| Number Of Beneficiaries Age 75 to 84 | 462 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 1454 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1563 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8158 |