| National Provider Identifier [NPI]: | 1275525958 |
| Last Name Of The Provider | PENNINGTON |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 CLINTON ST |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | MUSKEGON |
| Zip Code Of The Provider | 494425502 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 198 |
| Number Of Services | 7503 |
| Number Of Medicare Beneficiaries | 4681 |
| Total Submitted Charge Amount | 710604 |
| Total Medicare Allowed Amount | 193558.71 |
| Total Medicare Payment Amount | 158382.69 |
| Total Medicare Standardized Payment Amount | 163902.02 |
| 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 | 198 |
| Number Of Medical Services | 7503 |
| Number Of Medicare Beneficiaries With Medical Services | 4681 |
| Total Medical Submitted Charge Amount | 710604 |
| Total Medical Medicare Allowed Amount | 193558.71 |
| Total Medical Medicare Payment Amount | 158382.69 |
| Total Medical Medicare Standardized Payment Amount | 163902.02 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 1455 |
| Number Of Beneficiaries Age 65 to 74 | 1465 |
| Number Of Beneficiaries Age 75 to 84 | 1125 |
| Number Of Beneficiaries Age Greater 84 | 636 |
| Number Of Female Beneficiaries | 2995 |
| Number Of Male Beneficiaries | 1686 |
| Number Of Non Hispanic White Beneficiaries | 3867 |
| Number Of Black or African American Beneficiaries | 633 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 120 |
| Number Of American Indian Alaska Native Beneficiaries | 24 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2950 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1731 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.545 |