| National Provider Identifier [NPI]: | 1023295938 |
| Last Name Of The Provider | MCKENNA |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1909 VISTA DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LARAMIE |
| Zip Code Of The Provider | 820705530 |
| State Code Of The Provider | WY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 1941 |
| Number Of Medicare Beneficiaries | 340 |
| Total Submitted Charge Amount | 718208.58 |
| Total Medicare Allowed Amount | 156082.64 |
| Total Medicare Payment Amount | 115401.83 |
| Total Medicare Standardized Payment Amount | 115012.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 935 |
| Number Of Medicare Beneficiaries With Drug Services | 102 |
| Total Drug Submitted ChargeAmount | 12478.58 |
| Total Drug Medicare AllowedAmount | 10958.63 |
| Total Drug Medicare PaymentAmount | 8429.1 |
| Total Drug Medicare Standardized Payment Amount | 8429.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 1006 |
| Number Of Medicare Beneficiaries With Medical Services | 340 |
| Total Medical Submitted Charge Amount | 705730 |
| Total Medical Medicare Allowed Amount | 145124.01 |
| Total Medical Medicare Payment Amount | 106972.73 |
| Total Medical Medicare Standardized Payment Amount | 106583 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 160 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 191 |
| Number Of Male Beneficiaries | 149 |
| Number Of Non Hispanic White Beneficiaries | 309 |
| 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 | 292 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.905 |