| National Provider Identifier [NPI]: | 1942454749 |
| Last Name Of The Provider | PENN |
| First Name Of The Provider | STEVE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1758 SIERRA LEONE AVE STE A |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROWLAND HEIGHTS |
| Zip Code Of The Provider | 917485837 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 1483 |
| Number Of Medicare Beneficiaries | 1207 |
| Total Submitted Charge Amount | 249315 |
| Total Medicare Allowed Amount | 208114.8 |
| Total Medicare Payment Amount | 161079.17 |
| Total Medicare Standardized Payment Amount | 150500.97 |
| 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 | 20 |
| Number Of Medical Services | 1483 |
| Number Of Medicare Beneficiaries With Medical Services | 1207 |
| Total Medical Submitted Charge Amount | 249315 |
| Total Medical Medicare Allowed Amount | 208114.8 |
| Total Medical Medicare Payment Amount | 161079.17 |
| Total Medical Medicare Standardized Payment Amount | 150500.97 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 193 |
| Number Of Beneficiaries Age 65 to 74 | 306 |
| Number Of Beneficiaries Age 75 to 84 | 341 |
| Number Of Beneficiaries Age Greater 84 | 367 |
| Number Of Female Beneficiaries | 744 |
| Number Of Male Beneficiaries | 463 |
| Number Of Non Hispanic White Beneficiaries | 629 |
| Number Of Black or African American Beneficiaries | 158 |
| Number Of AsianPacific Islander Beneficiaries | 101 |
| Number Of Hispanic Beneficiaries | 303 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 88 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1119 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 66 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 56 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 38 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.9283 |