| National Provider Identifier [NPI]: | 1982665725 |
| Last Name Of The Provider | PENNOYER |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 701 COTTAGE GROVE ROAD |
| Street Address 2 Of The Provider | E110 |
| City Of The Provider | BLOOMFIELD |
| Zip Code Of The Provider | 06002 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 4238 |
| Number Of Medicare Beneficiaries | 877 |
| Total Submitted Charge Amount | 421987.5 |
| Total Medicare Allowed Amount | 223644.24 |
| Total Medicare Payment Amount | 158835.34 |
| Total Medicare Standardized Payment Amount | 144282.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 47 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 11910 |
| Total Drug Medicare AllowedAmount | 11524.07 |
| Total Drug Medicare PaymentAmount | 7651.85 |
| Total Drug Medicare Standardized Payment Amount | 7651.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 4191 |
| Number Of Medicare Beneficiaries With Medical Services | 877 |
| Total Medical Submitted Charge Amount | 410077.5 |
| Total Medical Medicare Allowed Amount | 212120.17 |
| Total Medical Medicare Payment Amount | 151183.49 |
| Total Medical Medicare Standardized Payment Amount | 136630.4 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 430 |
| Number Of Beneficiaries Age 75 to 84 | 313 |
| Number Of Beneficiaries Age Greater 84 | 117 |
| Number Of Female Beneficiaries | 621 |
| Number Of Male Beneficiaries | 256 |
| Number Of Non Hispanic White Beneficiaries | 840 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 848 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8285 |