| National Provider Identifier [NPI]: | 1699711358 |
| Last Name Of The Provider | MCKENNA |
| First Name Of The Provider | KATHLEEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 S SAN MATEO DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN MATEO |
| Zip Code Of The Provider | 944013805 |
| 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 | 103 |
| Number Of Services | 1910 |
| Number Of Medicare Beneficiaries | 1309 |
| Total Submitted Charge Amount | 186304 |
| Total Medicare Allowed Amount | 57375.39 |
| Total Medicare Payment Amount | 45874.68 |
| Total Medicare Standardized Payment Amount | 41559.95 |
| 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 | 103 |
| Number Of Medical Services | 1910 |
| Number Of Medicare Beneficiaries With Medical Services | 1309 |
| Total Medical Submitted Charge Amount | 186304 |
| Total Medical Medicare Allowed Amount | 57375.39 |
| Total Medical Medicare Payment Amount | 45874.68 |
| Total Medical Medicare Standardized Payment Amount | 41559.95 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 91 |
| Number Of Beneficiaries Age 65 to 74 | 546 |
| Number Of Beneficiaries Age 75 to 84 | 419 |
| Number Of Beneficiaries Age Greater 84 | 253 |
| Number Of Female Beneficiaries | 895 |
| Number Of Male Beneficiaries | 414 |
| Number Of Non Hispanic White Beneficiaries | 956 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 156 |
| Number Of Hispanic Beneficiaries | 129 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 42 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1139 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 170 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4215 |