| National Provider Identifier [NPI]: | 1629008974 |
| Last Name Of The Provider | MENENDEZ |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1151 OCEAN SPRINGS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | OCEAN SPRINGS |
| Zip Code Of The Provider | 39564 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 278 |
| Number Of Services | 9907 |
| Number Of Medicare Beneficiaries | 4507 |
| Total Submitted Charge Amount | 874571 |
| Total Medicare Allowed Amount | 278315.75 |
| Total Medicare Payment Amount | 208214.67 |
| Total Medicare Standardized Payment Amount | 224093.27 |
| 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 | 278 |
| Number Of Medical Services | 9907 |
| Number Of Medicare Beneficiaries With Medical Services | 4507 |
| Total Medical Submitted Charge Amount | 874571 |
| Total Medical Medicare Allowed Amount | 278315.75 |
| Total Medical Medicare Payment Amount | 208214.67 |
| Total Medical Medicare Standardized Payment Amount | 224093.27 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 922 |
| Number Of Beneficiaries Age 65 to 74 | 1805 |
| Number Of Beneficiaries Age 75 to 84 | 1286 |
| Number Of Beneficiaries Age Greater 84 | 494 |
| Number Of Female Beneficiaries | 2807 |
| Number Of Male Beneficiaries | 1700 |
| Number Of Non Hispanic White Beneficiaries | 3832 |
| Number Of Black or African American Beneficiaries | 489 |
| Number Of AsianPacific Islander Beneficiaries | 63 |
| Number Of Hispanic Beneficiaries | 75 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3452 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1055 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.488 |