National Provider Identifier [NPI]: |
1902989668 |
Last Name Of The Provider |
MENDOZA |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
23 UPPER RAGSDALE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MONTEREY |
Zip Code Of The Provider |
939407849 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
71 |
Number Of Services |
1547 |
Number Of Medicare Beneficiaries |
547 |
Total Submitted Charge Amount |
426227.26 |
Total Medicare Allowed Amount |
236700.91 |
Total Medicare Payment Amount |
182293.81 |
Total Medicare Standardized Payment Amount |
180176.86 |
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 |
71 |
Number Of Medical Services |
1547 |
Number Of Medicare Beneficiaries With Medical Services |
547 |
Total Medical Submitted Charge Amount |
426227.26 |
Total Medical Medicare Allowed Amount |
236700.91 |
Total Medical Medicare Payment Amount |
182293.81 |
Total Medical Medicare Standardized Payment Amount |
180176.86 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
210 |
Number Of Beneficiaries Age 75 to 84 |
173 |
Number Of Beneficiaries Age Greater 84 |
90 |
Number Of Female Beneficiaries |
287 |
Number Of Male Beneficiaries |
260 |
Number Of Non Hispanic White Beneficiaries |
374 |
Number Of Black or African American Beneficiaries |
39 |
Number Of AsianPacific Islander Beneficiaries |
33 |
Number Of Hispanic Beneficiaries |
88 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
427 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
120 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6528 |