| National Provider Identifier [NPI]: | 1609892256 |
| Last Name Of The Provider | MENA |
| First Name Of The Provider | RAUL |
| 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 | 181 S BUENA VISTA ST |
| Street Address 2 Of The Provider | 4RTH FLOOR |
| City Of The Provider | BURBANK |
| Zip Code Of The Provider | 915054504 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 143 |
| Number Of Services | 105011 |
| Number Of Medicare Beneficiaries | 640 |
| Total Submitted Charge Amount | 4177192.58 |
| Total Medicare Allowed Amount | 2203870.32 |
| Total Medicare Payment Amount | 1744264.66 |
| Total Medicare Standardized Payment Amount | 1696611.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 60 |
| Number Of Drug Services | 78345 |
| Number Of Medicare Beneficiaries With Drug Services | 315 |
| Total Drug Submitted ChargeAmount | 2617541.04 |
| Total Drug Medicare AllowedAmount | 1367971.63 |
| Total Drug Medicare PaymentAmount | 1074389.17 |
| Total Drug Medicare Standardized Payment Amount | 1074389.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 26666 |
| Number Of Medicare Beneficiaries With Medical Services | 640 |
| Total Medical Submitted Charge Amount | 1559651.54 |
| Total Medical Medicare Allowed Amount | 835898.69 |
| Total Medical Medicare Payment Amount | 669875.49 |
| Total Medical Medicare Standardized Payment Amount | 622222.39 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 248 |
| Number Of Beneficiaries Age 75 to 84 | 232 |
| Number Of Beneficiaries Age Greater 84 | 117 |
| Number Of Female Beneficiaries | 413 |
| Number Of Male Beneficiaries | 227 |
| Number Of Non Hispanic White Beneficiaries | 460 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | 123 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 509 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 131 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 53 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.8538 |