| National Provider Identifier [NPI]: | 1295775922 |
| Last Name Of The Provider | PENN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 211 E MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CARBONDALE |
| Zip Code Of The Provider | 664149607 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 2491 |
| Number Of Medicare Beneficiaries | 507 |
| Total Submitted Charge Amount | 166505.38 |
| Total Medicare Allowed Amount | 123764.2 |
| Total Medicare Payment Amount | 88353.53 |
| Total Medicare Standardized Payment Amount | 95012.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 334 |
| Number Of Medicare Beneficiaries With Drug Services | 252 |
| Total Drug Submitted ChargeAmount | 17189 |
| Total Drug Medicare AllowedAmount | 14975.17 |
| Total Drug Medicare PaymentAmount | 14630.28 |
| Total Drug Medicare Standardized Payment Amount | 14630.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 2157 |
| Number Of Medicare Beneficiaries With Medical Services | 505 |
| Total Medical Submitted Charge Amount | 149316.38 |
| Total Medical Medicare Allowed Amount | 108789.03 |
| Total Medical Medicare Payment Amount | 73723.25 |
| Total Medical Medicare Standardized Payment Amount | 80381.79 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 206 |
| Number Of Beneficiaries Age 75 to 84 | 156 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 280 |
| Number Of Male Beneficiaries | 227 |
| Number Of Non Hispanic White Beneficiaries | 492 |
| 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 | 438 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9261 |