| National Provider Identifier [NPI]: | 1417101809 |
| Last Name Of The Provider | SANNA |
| First Name Of The Provider | MAIJA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 757 WESTWOOD PLZ |
| Street Address 2 Of The Provider | RR UCLA MEDICAL CENTER, HOUSESTAFF MAILROOM, ROOM B-711 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900958358 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 2624 |
| Number Of Medicare Beneficiaries | 586 |
| Total Submitted Charge Amount | 658980.9 |
| Total Medicare Allowed Amount | 221358.34 |
| Total Medicare Payment Amount | 166626.58 |
| Total Medicare Standardized Payment Amount | 155056.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 186 |
| Number Of Medicare Beneficiaries With Drug Services | 117 |
| Total Drug Submitted ChargeAmount | 29540.9 |
| Total Drug Medicare AllowedAmount | 9735.3 |
| Total Drug Medicare PaymentAmount | 9536.86 |
| Total Drug Medicare Standardized Payment Amount | 9536.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 2438 |
| Number Of Medicare Beneficiaries With Medical Services | 586 |
| Total Medical Submitted Charge Amount | 629440 |
| Total Medical Medicare Allowed Amount | 211623.04 |
| Total Medical Medicare Payment Amount | 157089.72 |
| Total Medical Medicare Standardized Payment Amount | 145519.39 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 150 |
| Number Of Beneficiaries Age 75 to 84 | 163 |
| Number Of Beneficiaries Age Greater 84 | 234 |
| Number Of Female Beneficiaries | 386 |
| Number Of Male Beneficiaries | 200 |
| Number Of Non Hispanic White Beneficiaries | 415 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | 48 |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 414 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 172 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 34 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 24 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.867 |