| National Provider Identifier [NPI]: | 1215918834 |
| Last Name Of The Provider | PENA |
| First Name Of The Provider | ANNIE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3705 MEDICAL PKWY |
| Street Address 2 Of The Provider | SUITE 570 |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787051019 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 548 |
| Number Of Medicare Beneficiaries | 497 |
| Total Submitted Charge Amount | 273836.5 |
| Total Medicare Allowed Amount | 51656.61 |
| Total Medicare Payment Amount | 40190.02 |
| Total Medicare Standardized Payment Amount | 41850.18 |
| 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 | 48 |
| Number Of Medical Services | 548 |
| Number Of Medicare Beneficiaries With Medical Services | 497 |
| Total Medical Submitted Charge Amount | 273836.5 |
| Total Medical Medicare Allowed Amount | 51656.61 |
| Total Medical Medicare Payment Amount | 40190.02 |
| Total Medical Medicare Standardized Payment Amount | 41850.18 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 255 |
| Number Of Beneficiaries Age 75 to 84 | 163 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 283 |
| Number Of Male Beneficiaries | 214 |
| Number Of Non Hispanic White Beneficiaries | 415 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 445 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1682 |