| National Provider Identifier [NPI]: | 1821163312 |
| Last Name Of The Provider | CELENTANO |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 305 BICENTENNIAL HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011181962 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 669 |
| Number Of Medicare Beneficiaries | 380 |
| Total Submitted Charge Amount | 120445 |
| Total Medicare Allowed Amount | 64383.3 |
| Total Medicare Payment Amount | 42863.54 |
| Total Medicare Standardized Payment Amount | 42008.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 669 |
| Number Of Medicare Beneficiaries With Medical Services | 380 |
| Total Medical Submitted Charge Amount | 120445 |
| Total Medical Medicare Allowed Amount | 64383.3 |
| Total Medical Medicare Payment Amount | 42863.54 |
| Total Medical Medicare Standardized Payment Amount | 42008.58 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 159 |
| Number Of Beneficiaries Age 65 to 74 | 164 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 231 |
| Number Of Male Beneficiaries | 149 |
| Number Of Non Hispanic White Beneficiaries | 200 |
| Number Of Black or African American Beneficiaries | 81 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 85 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 181 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 199 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1223 |