| National Provider Identifier [NPI]: | 1770773905 |
| Last Name Of The Provider | PENN |
| First Name Of The Provider | ERICKA |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 W BIG BEAVER RD |
| Street Address 2 Of The Provider | SUITE 655 |
| City Of The Provider | TROY |
| Zip Code Of The Provider | 480845206 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 1744 |
| Number Of Medicare Beneficiaries | 694 |
| Total Submitted Charge Amount | 91265.06 |
| Total Medicare Allowed Amount | 80287.73 |
| Total Medicare Payment Amount | 49951.33 |
| Total Medicare Standardized Payment Amount | 52681.76 |
| 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 | 15 |
| Number Of Medical Services | 1744 |
| Number Of Medicare Beneficiaries With Medical Services | 694 |
| Total Medical Submitted Charge Amount | 91265.06 |
| Total Medical Medicare Allowed Amount | 80287.73 |
| Total Medical Medicare Payment Amount | 49951.33 |
| Total Medical Medicare Standardized Payment Amount | 52681.76 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 106 |
| Number Of Beneficiaries Age 75 to 84 | 195 |
| Number Of Beneficiaries Age Greater 84 | 315 |
| Number Of Female Beneficiaries | 474 |
| Number Of Male Beneficiaries | 220 |
| Number Of Non Hispanic White Beneficiaries | 598 |
| Number Of Black or African American Beneficiaries | 66 |
| 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 | 90 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 604 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 65 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 33 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.3961 |