| National Provider Identifier [NPI]: | 1659359420 |
| Last Name Of The Provider | MENA |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2835 W DE LEON ST |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336094130 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 3399 |
| Number Of Medicare Beneficiaries | 595 |
| Total Submitted Charge Amount | 344470 |
| Total Medicare Allowed Amount | 274152.49 |
| Total Medicare Payment Amount | 202940.22 |
| Total Medicare Standardized Payment Amount | 203082.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 94 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 2320 |
| Total Drug Medicare AllowedAmount | 98.29 |
| Total Drug Medicare PaymentAmount | 70.4 |
| Total Drug Medicare Standardized Payment Amount | 70.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 3305 |
| Number Of Medicare Beneficiaries With Medical Services | 595 |
| Total Medical Submitted Charge Amount | 342150 |
| Total Medical Medicare Allowed Amount | 274054.2 |
| Total Medical Medicare Payment Amount | 202869.82 |
| Total Medical Medicare Standardized Payment Amount | 203012.47 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 226 |
| Number Of Beneficiaries Age 75 to 84 | 189 |
| Number Of Beneficiaries Age Greater 84 | 122 |
| Number Of Female Beneficiaries | 340 |
| Number Of Male Beneficiaries | 255 |
| Number Of Non Hispanic White Beneficiaries | 455 |
| Number Of Black or African American Beneficiaries | 39 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 89 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 504 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 91 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4394 |