| National Provider Identifier [NPI]: | 1629029335 |
| Last Name Of The Provider | TENA |
| First Name Of The Provider | ROWENA |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 501 WASHINGTON ST |
| Street Address 2 Of The Provider | STE 510 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921032231 |
| 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 | 130 |
| Number Of Services | 4735 |
| Number Of Medicare Beneficiaries | 2106 |
| Total Submitted Charge Amount | 1048886.96 |
| Total Medicare Allowed Amount | 286672.15 |
| Total Medicare Payment Amount | 242543.72 |
| Total Medicare Standardized Payment Amount | 231078.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 836 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 5232 |
| Total Drug Medicare AllowedAmount | 695.46 |
| Total Drug Medicare PaymentAmount | 545.25 |
| Total Drug Medicare Standardized Payment Amount | 545.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 127 |
| Number Of Medical Services | 3899 |
| Number Of Medicare Beneficiaries With Medical Services | 2106 |
| Total Medical Submitted Charge Amount | 1043654.96 |
| Total Medical Medicare Allowed Amount | 285976.69 |
| Total Medical Medicare Payment Amount | 241998.47 |
| Total Medical Medicare Standardized Payment Amount | 230532.91 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 289 |
| Number Of Beneficiaries Age 65 to 74 | 1049 |
| Number Of Beneficiaries Age 75 to 84 | 529 |
| Number Of Beneficiaries Age Greater 84 | 239 |
| Number Of Female Beneficiaries | 1658 |
| Number Of Male Beneficiaries | 448 |
| Number Of Non Hispanic White Beneficiaries | 1505 |
| Number Of Black or African American Beneficiaries | 136 |
| Number Of AsianPacific Islander Beneficiaries | 126 |
| Number Of Hispanic Beneficiaries | 272 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1477 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 629 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4108 |