| National Provider Identifier [NPI]: | 1720074099 |
| Last Name Of The Provider | MENCO |
| First Name Of The Provider | HARRY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 227 W JANSS RD |
| Street Address 2 Of The Provider | # 310 |
| City Of The Provider | THOUSAND OAKS |
| Zip Code Of The Provider | 913601848 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 143477 |
| Number Of Medicare Beneficiaries | 484 |
| Total Submitted Charge Amount | 4752083.19 |
| Total Medicare Allowed Amount | 1554028.85 |
| Total Medicare Payment Amount | 1215148.87 |
| Total Medicare Standardized Payment Amount | 1183502.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 49 |
| Number Of Drug Services | 134671 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 3569434.79 |
| Total Drug Medicare AllowedAmount | 1148911.79 |
| Total Drug Medicare PaymentAmount | 896445.99 |
| Total Drug Medicare Standardized Payment Amount | 896445.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 8806 |
| Number Of Medicare Beneficiaries With Medical Services | 484 |
| Total Medical Submitted Charge Amount | 1182648.4 |
| Total Medical Medicare Allowed Amount | 405117.06 |
| Total Medical Medicare Payment Amount | 318702.88 |
| Total Medical Medicare Standardized Payment Amount | 287056.7 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 186 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 282 |
| Number Of Male Beneficiaries | 202 |
| Number Of Non Hispanic White Beneficiaries | 439 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 461 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 46 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.6012 |