| National Provider Identifier [NPI]: | 1568427078 |
| Last Name Of The Provider | PENA |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2488 N UNIVERSITY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | PEMBROKE PINES |
| Zip Code Of The Provider | 330243624 |
| 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 | 25 |
| Number Of Services | 2130 |
| Number Of Medicare Beneficiaries | 516 |
| Total Submitted Charge Amount | 200398.72 |
| Total Medicare Allowed Amount | 148649.99 |
| Total Medicare Payment Amount | 111936.52 |
| Total Medicare Standardized Payment Amount | 106992.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 432 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 3600 |
| Total Drug Medicare AllowedAmount | 768.14 |
| Total Drug Medicare PaymentAmount | 719.88 |
| Total Drug Medicare Standardized Payment Amount | 719.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 1698 |
| Number Of Medicare Beneficiaries With Medical Services | 516 |
| Total Medical Submitted Charge Amount | 196798.72 |
| Total Medical Medicare Allowed Amount | 147881.85 |
| Total Medical Medicare Payment Amount | 111216.64 |
| Total Medical Medicare Standardized Payment Amount | 106272.17 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 132 |
| Number Of Beneficiaries Age 65 to 74 | 194 |
| Number Of Beneficiaries Age 75 to 84 | 126 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 333 |
| Number Of Male Beneficiaries | 183 |
| Number Of Non Hispanic White Beneficiaries | 203 |
| Number Of Black or African American Beneficiaries | 69 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 221 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 227 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 289 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.5405 |