| National Provider Identifier [NPI]: | 1255374856 |
| Last Name Of The Provider | MENDOZA |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 604 ANN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PARKERSBURG |
| Zip Code Of The Provider | 261015122 |
| State Code Of The Provider | WV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 3230 |
| Number Of Medicare Beneficiaries | 894 |
| Total Submitted Charge Amount | 832906.25 |
| Total Medicare Allowed Amount | 287606.81 |
| Total Medicare Payment Amount | 213110.38 |
| Total Medicare Standardized Payment Amount | 226828.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 270 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 67564 |
| Total Drug Medicare AllowedAmount | 41945.56 |
| Total Drug Medicare PaymentAmount | 32623.08 |
| Total Drug Medicare Standardized Payment Amount | 32623.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 107 |
| Number Of Medical Services | 2960 |
| Number Of Medicare Beneficiaries With Medical Services | 894 |
| Total Medical Submitted Charge Amount | 765342.25 |
| Total Medical Medicare Allowed Amount | 245661.25 |
| Total Medical Medicare Payment Amount | 180487.3 |
| Total Medical Medicare Standardized Payment Amount | 194205.83 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 101 |
| Number Of Beneficiaries Age 65 to 74 | 338 |
| Number Of Beneficiaries Age 75 to 84 | 339 |
| Number Of Beneficiaries Age Greater 84 | 116 |
| Number Of Female Beneficiaries | 234 |
| Number Of Male Beneficiaries | 660 |
| Number Of Non Hispanic White Beneficiaries | 880 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 757 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 137 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2439 |