| National Provider Identifier [NPI]: | 1295767028 |
| Last Name Of The Provider | PENO-GREEN |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 WHITCHER ST NE |
| Street Address 2 Of The Provider | SUITE 160 |
| City Of The Provider | MARIETTA |
| Zip Code Of The Provider | 300601155 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 2515 |
| Number Of Medicare Beneficiaries | 733 |
| Total Submitted Charge Amount | 500308 |
| Total Medicare Allowed Amount | 238388.19 |
| Total Medicare Payment Amount | 178987.55 |
| Total Medicare Standardized Payment Amount | 182375.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 63 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 4996 |
| Total Drug Medicare AllowedAmount | 2577.62 |
| Total Drug Medicare PaymentAmount | 2519.36 |
| Total Drug Medicare Standardized Payment Amount | 2519.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 2452 |
| Number Of Medicare Beneficiaries With Medical Services | 733 |
| Total Medical Submitted Charge Amount | 495312 |
| Total Medical Medicare Allowed Amount | 235810.57 |
| Total Medical Medicare Payment Amount | 176468.19 |
| Total Medical Medicare Standardized Payment Amount | 179856.07 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 155 |
| Number Of Beneficiaries Age 65 to 74 | 308 |
| Number Of Beneficiaries Age 75 to 84 | 195 |
| Number Of Beneficiaries Age Greater 84 | 75 |
| Number Of Female Beneficiaries | 433 |
| Number Of Male Beneficiaries | 300 |
| Number Of Non Hispanic White Beneficiaries | 648 |
| Number Of Black or African American Beneficiaries | 68 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 558 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 175 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 62 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.295 |