| National Provider Identifier [NPI]: | 1679624936 |
| Last Name Of The Provider | JENSEN |
| First Name Of The Provider | LAURENCE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1925 E ORMAN AVE |
| Street Address 2 Of The Provider | SUITE A535 |
| City Of The Provider | PUEBLO |
| Zip Code Of The Provider | 810043537 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 4345 |
| Number Of Medicare Beneficiaries | 480 |
| Total Submitted Charge Amount | 367604.42 |
| Total Medicare Allowed Amount | 258508.32 |
| Total Medicare Payment Amount | 186505.53 |
| Total Medicare Standardized Payment Amount | 181667.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 738 |
| Number Of Medicare Beneficiaries With Drug Services | 249 |
| Total Drug Submitted ChargeAmount | 16536 |
| Total Drug Medicare AllowedAmount | 8409.7 |
| Total Drug Medicare PaymentAmount | 7802.69 |
| Total Drug Medicare Standardized Payment Amount | 7802.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 3607 |
| Number Of Medicare Beneficiaries With Medical Services | 480 |
| Total Medical Submitted Charge Amount | 351068.42 |
| Total Medical Medicare Allowed Amount | 250098.62 |
| Total Medical Medicare Payment Amount | 178702.84 |
| Total Medical Medicare Standardized Payment Amount | 173864.76 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 133 |
| Number Of Beneficiaries Age 75 to 84 | 190 |
| Number Of Beneficiaries Age Greater 84 | 142 |
| Number Of Female Beneficiaries | 264 |
| Number Of Male Beneficiaries | 216 |
| Number Of Non Hispanic White Beneficiaries | 390 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 77 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 435 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 45 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.2595 |