| National Provider Identifier [NPI]: | 1356336614 |
| Last Name Of The Provider | ITENBERG |
| First Name Of The Provider | ILANA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 280 MAIN ST |
| Street Address 2 Of The Provider | SUITE 321 |
| City Of The Provider | NASHUA |
| Zip Code Of The Provider | 030602919 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 1342 |
| Number Of Medicare Beneficiaries | 354 |
| Total Submitted Charge Amount | 209581 |
| Total Medicare Allowed Amount | 86535.7 |
| Total Medicare Payment Amount | 62789.29 |
| Total Medicare Standardized Payment Amount | 62372.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 448 |
| Total Drug Medicare AllowedAmount | 183.11 |
| Total Drug Medicare PaymentAmount | 143.59 |
| Total Drug Medicare Standardized Payment Amount | 143.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 1310 |
| Number Of Medicare Beneficiaries With Medical Services | 354 |
| Total Medical Submitted Charge Amount | 209133 |
| Total Medical Medicare Allowed Amount | 86352.59 |
| Total Medical Medicare Payment Amount | 62645.7 |
| Total Medical Medicare Standardized Payment Amount | 62228.42 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 85 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 226 |
| Number Of Male Beneficiaries | 128 |
| Number Of Non Hispanic White Beneficiaries | 335 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 286 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3322 |