| National Provider Identifier [NPI]: | 1982648036 |
| Last Name Of The Provider | MENDOZA |
| First Name Of The Provider | JOSE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8926 WOODYARD RD |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | CLINTON |
| Zip Code Of The Provider | 207354220 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 209963 |
| Number Of Medicare Beneficiaries | 1168 |
| Total Submitted Charge Amount | 8125458 |
| Total Medicare Allowed Amount | 2406618.05 |
| Total Medicare Payment Amount | 1885653.2 |
| Total Medicare Standardized Payment Amount | 1845836.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 74 |
| Number Of Drug Services | 196253 |
| Number Of Medicare Beneficiaries With Drug Services | 547 |
| Total Drug Submitted ChargeAmount | 6670403 |
| Total Drug Medicare AllowedAmount | 1945482.93 |
| Total Drug Medicare PaymentAmount | 1520862.07 |
| Total Drug Medicare Standardized Payment Amount | 1520862.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 13710 |
| Number Of Medicare Beneficiaries With Medical Services | 1167 |
| Total Medical Submitted Charge Amount | 1455055 |
| Total Medical Medicare Allowed Amount | 461135.12 |
| Total Medical Medicare Payment Amount | 364791.13 |
| Total Medical Medicare Standardized Payment Amount | 324974.69 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 141 |
| Number Of Beneficiaries Age 65 to 74 | 502 |
| Number Of Beneficiaries Age 75 to 84 | 389 |
| Number Of Beneficiaries Age Greater 84 | 136 |
| Number Of Female Beneficiaries | 750 |
| Number Of Male Beneficiaries | 418 |
| Number Of Non Hispanic White Beneficiaries | 394 |
| Number Of Black or African American Beneficiaries | 741 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 998 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 170 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 38 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.8843 |