| National Provider Identifier [NPI]: | 1427091024 |
| Last Name Of The Provider | RENNA |
| First Name Of The Provider | THEODORE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 454 OLD STREET RD |
| Street Address 2 Of The Provider | SUITE 204 |
| City Of The Provider | PETERBOROUGH |
| Zip Code Of The Provider | 034581200 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 3611 |
| Number Of Medicare Beneficiaries | 1139 |
| Total Submitted Charge Amount | 579765 |
| Total Medicare Allowed Amount | 398850.18 |
| Total Medicare Payment Amount | 282483.76 |
| Total Medicare Standardized Payment Amount | 277021.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 147 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 64745 |
| Total Drug Medicare AllowedAmount | 53333.22 |
| Total Drug Medicare PaymentAmount | 40892.38 |
| Total Drug Medicare Standardized Payment Amount | 40892.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 3464 |
| Number Of Medicare Beneficiaries With Medical Services | 1136 |
| Total Medical Submitted Charge Amount | 515020 |
| Total Medical Medicare Allowed Amount | 345516.96 |
| Total Medical Medicare Payment Amount | 241591.38 |
| Total Medical Medicare Standardized Payment Amount | 236129.39 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 360 |
| Number Of Beneficiaries Age 75 to 84 | 428 |
| Number Of Beneficiaries Age Greater 84 | 320 |
| Number Of Female Beneficiaries | 650 |
| Number Of Male Beneficiaries | 489 |
| Number Of Non Hispanic White Beneficiaries | 1113 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1097 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0019 |