| National Provider Identifier [NPI]: | 1497932784 |
| Last Name Of The Provider | PENNIE |
| First Name Of The Provider | MICHELLE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 900 PINE ST |
| Street Address 2 Of The Provider | STE 122-123 |
| City Of The Provider | ENGLEWOOD |
| Zip Code Of The Provider | 342234418 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 11499 |
| Number Of Medicare Beneficiaries | 1521 |
| Total Submitted Charge Amount | 1706128.64 |
| Total Medicare Allowed Amount | 1128023.18 |
| Total Medicare Payment Amount | 856185.65 |
| Total Medicare Standardized Payment Amount | 824015.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 182 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 15602.39 |
| Total Drug Medicare AllowedAmount | 12183.87 |
| Total Drug Medicare PaymentAmount | 9532.23 |
| Total Drug Medicare Standardized Payment Amount | 9532.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 11317 |
| Number Of Medicare Beneficiaries With Medical Services | 1521 |
| Total Medical Submitted Charge Amount | 1690526.25 |
| Total Medical Medicare Allowed Amount | 1115839.31 |
| Total Medical Medicare Payment Amount | 846653.42 |
| Total Medical Medicare Standardized Payment Amount | 814483.47 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 649 |
| Number Of Beneficiaries Age 75 to 84 | 546 |
| Number Of Beneficiaries Age Greater 84 | 284 |
| Number Of Female Beneficiaries | 834 |
| Number Of Male Beneficiaries | 687 |
| Number Of Non Hispanic White Beneficiaries | 1490 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1490 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0034 |