| National Provider Identifier [NPI]: | 1306007679 |
| Last Name Of The Provider | LESSNER |
| First Name Of The Provider | JENNY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1001 NOBLE ST |
| Street Address 2 Of The Provider | TANANA VALLEY CLINIC |
| City Of The Provider | FAIRBANKS |
| Zip Code Of The Provider | 997014922 |
| State Code Of The Provider | AK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 377 |
| Number Of Medicare Beneficiaries | 112 |
| Total Submitted Charge Amount | 77976 |
| Total Medicare Allowed Amount | 41323.82 |
| Total Medicare Payment Amount | 29267.27 |
| Total Medicare Standardized Payment Amount | 23926.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 1739 |
| Total Drug Medicare AllowedAmount | 1292.32 |
| Total Drug Medicare PaymentAmount | 1240.84 |
| Total Drug Medicare Standardized Payment Amount | 1240.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 337 |
| Number Of Medicare Beneficiaries With Medical Services | 112 |
| Total Medical Submitted Charge Amount | 76237 |
| Total Medical Medicare Allowed Amount | 40031.5 |
| Total Medical Medicare Payment Amount | 28026.43 |
| Total Medical Medicare Standardized Payment Amount | 22685.83 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 68 |
| Number Of Beneficiaries Age 75 to 84 | 20 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 78 |
| Number Of Male Beneficiaries | 34 |
| 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 | 94 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8138 |