| National Provider Identifier [NPI]: | 1205053832 |
| Last Name Of The Provider | JENSEN |
| First Name Of The Provider | LEIF |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD MPH |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 HIGHLAND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MADISON |
| Zip Code Of The Provider | 537920001 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 3430 |
| Number Of Medicare Beneficiaries | 1966 |
| Total Submitted Charge Amount | 264443.35 |
| Total Medicare Allowed Amount | 78255.26 |
| Total Medicare Payment Amount | 55611.59 |
| Total Medicare Standardized Payment Amount | 59987.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 3430 |
| Number Of Medicare Beneficiaries With Medical Services | 1966 |
| Total Medical Submitted Charge Amount | 264443.35 |
| Total Medical Medicare Allowed Amount | 78255.26 |
| Total Medical Medicare Payment Amount | 55611.59 |
| Total Medical Medicare Standardized Payment Amount | 59987.01 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 394 |
| Number Of Beneficiaries Age 65 to 74 | 863 |
| Number Of Beneficiaries Age 75 to 84 | 509 |
| Number Of Beneficiaries Age Greater 84 | 200 |
| Number Of Female Beneficiaries | 944 |
| Number Of Male Beneficiaries | 1022 |
| Number Of Non Hispanic White Beneficiaries | 1674 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | 58 |
| Number Of Hispanic Beneficiaries | 146 |
| Number Of American Indian Alaska Native Beneficiaries | 33 |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1561 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 405 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0204 |