| National Provider Identifier [NPI]: | 1881650398 |
| Last Name Of The Provider | PENA |
| First Name Of The Provider | MARIO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5130 82ND ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LUBBOCK |
| Zip Code Of The Provider | 794243024 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 1599 |
| Number Of Medicare Beneficiaries | 226 |
| Total Submitted Charge Amount | 95629 |
| Total Medicare Allowed Amount | 47922.39 |
| Total Medicare Payment Amount | 31716.5 |
| Total Medicare Standardized Payment Amount | 34216 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 436 |
| Number Of Medicare Beneficiaries With Drug Services | 125 |
| Total Drug Submitted ChargeAmount | 7950 |
| Total Drug Medicare AllowedAmount | 1606.66 |
| Total Drug Medicare PaymentAmount | 1131.61 |
| Total Drug Medicare Standardized Payment Amount | 1131.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 1163 |
| Number Of Medicare Beneficiaries With Medical Services | 226 |
| Total Medical Submitted Charge Amount | 87679 |
| Total Medical Medicare Allowed Amount | 46315.73 |
| Total Medical Medicare Payment Amount | 30584.89 |
| Total Medical Medicare Standardized Payment Amount | 33084.39 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 61 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 113 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 184 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 214 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 0.8482 |