| National Provider Identifier [NPI]: | 1285633842 |
| Last Name Of The Provider | PENUEL |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 821 N COBB ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILLEDGEVILLE |
| Zip Code Of The Provider | 310612343 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 191 |
| Number Of Services | 9610 |
| Number Of Medicare Beneficiaries | 2650 |
| Total Submitted Charge Amount | 747377.8 |
| Total Medicare Allowed Amount | 183878.46 |
| Total Medicare Payment Amount | 134675.98 |
| Total Medicare Standardized Payment Amount | 143753.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3950 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 16102 |
| Total Drug Medicare AllowedAmount | 1142.98 |
| Total Drug Medicare PaymentAmount | 896.06 |
| Total Drug Medicare Standardized Payment Amount | 896.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 188 |
| Number Of Medical Services | 5660 |
| Number Of Medicare Beneficiaries With Medical Services | 2650 |
| Total Medical Submitted Charge Amount | 731275.8 |
| Total Medical Medicare Allowed Amount | 182735.48 |
| Total Medical Medicare Payment Amount | 133779.92 |
| Total Medical Medicare Standardized Payment Amount | 142857.83 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 632 |
| Number Of Beneficiaries Age 65 to 74 | 971 |
| Number Of Beneficiaries Age 75 to 84 | 665 |
| Number Of Beneficiaries Age Greater 84 | 382 |
| Number Of Female Beneficiaries | 1590 |
| Number Of Male Beneficiaries | 1060 |
| Number Of Non Hispanic White Beneficiaries | 1778 |
| Number Of Black or African American Beneficiaries | 840 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1815 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 835 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6246 |