| National Provider Identifier [NPI]: | 1316935042 |
| Last Name Of The Provider | MENDOZA |
| First Name Of The Provider | FRED |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6367 E TANQUE VERDE ROAD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857153832 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 7729 |
| Number Of Medicare Beneficiaries | 719 |
| Total Submitted Charge Amount | 486750.8 |
| Total Medicare Allowed Amount | 276646.92 |
| Total Medicare Payment Amount | 215120.28 |
| Total Medicare Standardized Payment Amount | 218077.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 815 |
| Number Of Medicare Beneficiaries With Drug Services | 132 |
| Total Drug Submitted ChargeAmount | 18114 |
| Total Drug Medicare AllowedAmount | 7876.52 |
| Total Drug Medicare PaymentAmount | 6733.49 |
| Total Drug Medicare Standardized Payment Amount | 6733.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 146 |
| Number Of Medical Services | 6914 |
| Number Of Medicare Beneficiaries With Medical Services | 719 |
| Total Medical Submitted Charge Amount | 468636.8 |
| Total Medical Medicare Allowed Amount | 268770.4 |
| Total Medical Medicare Payment Amount | 208386.79 |
| Total Medical Medicare Standardized Payment Amount | 211344.37 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 342 |
| Number Of Beneficiaries Age 75 to 84 | 263 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 436 |
| Number Of Male Beneficiaries | 283 |
| Number Of Non Hispanic White Beneficiaries | 680 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9223 |