| National Provider Identifier [NPI]: | 1164750030 |
| Last Name Of The Provider | RENNA |
| First Name Of The Provider | MARIA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD, PHD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 151 HAZARD AVE |
| Street Address 2 Of The Provider | SUITE 9 |
| City Of The Provider | ENFIELD |
| Zip Code Of The Provider | 060823888 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 729 |
| Number Of Medicare Beneficiaries | 176 |
| Total Submitted Charge Amount | 139916 |
| Total Medicare Allowed Amount | 78181.44 |
| Total Medicare Payment Amount | 56487.48 |
| Total Medicare Standardized Payment Amount | 53116.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 30 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 1146 |
| Total Drug Medicare AllowedAmount | 780.91 |
| Total Drug Medicare PaymentAmount | 733.09 |
| Total Drug Medicare Standardized Payment Amount | 733.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 699 |
| Number Of Medicare Beneficiaries With Medical Services | 176 |
| Total Medical Submitted Charge Amount | 138770 |
| Total Medical Medicare Allowed Amount | 77400.53 |
| Total Medical Medicare Payment Amount | 55754.39 |
| Total Medical Medicare Standardized Payment Amount | 52383.64 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 35 |
| Number Of Beneficiaries Age 75 to 84 | 49 |
| Number Of Beneficiaries Age Greater 84 | 76 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 53 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 106 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 44 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.8691 |