| National Provider Identifier [NPI]: | 1952514978 |
| Last Name Of The Provider | LIU |
| First Name Of The Provider | JENNA |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8881 FLETCHER PARKWAY |
| Street Address 2 Of The Provider | #102 |
| City Of The Provider | LA MESA |
| Zip Code Of The Provider | 91942 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 163 |
| Number Of Services | 8300 |
| Number Of Medicare Beneficiaries | 3044 |
| Total Submitted Charge Amount | 1023084 |
| Total Medicare Allowed Amount | 259199.6 |
| Total Medicare Payment Amount | 199759.38 |
| Total Medicare Standardized Payment Amount | 192019.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3336 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 8072 |
| Total Drug Medicare AllowedAmount | 964.71 |
| Total Drug Medicare PaymentAmount | 737.66 |
| Total Drug Medicare Standardized Payment Amount | 737.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 160 |
| Number Of Medical Services | 4964 |
| Number Of Medicare Beneficiaries With Medical Services | 3044 |
| Total Medical Submitted Charge Amount | 1015012 |
| Total Medical Medicare Allowed Amount | 258234.89 |
| Total Medical Medicare Payment Amount | 199021.72 |
| Total Medical Medicare Standardized Payment Amount | 191282.01 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 656 |
| Number Of Beneficiaries Age 65 to 74 | 1065 |
| Number Of Beneficiaries Age 75 to 84 | 807 |
| Number Of Beneficiaries Age Greater 84 | 516 |
| Number Of Female Beneficiaries | 1976 |
| Number Of Male Beneficiaries | 1068 |
| Number Of Non Hispanic White Beneficiaries | 2217 |
| Number Of Black or African American Beneficiaries | 193 |
| Number Of AsianPacific Islander Beneficiaries | 127 |
| Number Of Hispanic Beneficiaries | 401 |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | 87 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1665 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1379 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9452 |