| National Provider Identifier [NPI]: | 1538159314 |
| Last Name Of The Provider | MONG |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3410 KIMBALL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WATERLOO |
| Zip Code Of The Provider | 507025735 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 5001 |
| Number Of Medicare Beneficiaries | 1098 |
| Total Submitted Charge Amount | 728057 |
| Total Medicare Allowed Amount | 336966.73 |
| Total Medicare Payment Amount | 240995.25 |
| Total Medicare Standardized Payment Amount | 259771.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 207 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 178452 |
| Total Drug Medicare AllowedAmount | 44885.37 |
| Total Drug Medicare PaymentAmount | 35044.4 |
| Total Drug Medicare Standardized Payment Amount | 35044.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 4794 |
| Number Of Medicare Beneficiaries With Medical Services | 1098 |
| Total Medical Submitted Charge Amount | 549605 |
| Total Medical Medicare Allowed Amount | 292081.36 |
| Total Medical Medicare Payment Amount | 205950.85 |
| Total Medical Medicare Standardized Payment Amount | 224727.26 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 419 |
| Number Of Beneficiaries Age 75 to 84 | 427 |
| Number Of Beneficiaries Age Greater 84 | 189 |
| Number Of Female Beneficiaries | 215 |
| Number Of Male Beneficiaries | 883 |
| Number Of Non Hispanic White Beneficiaries | 1041 |
| Number Of Black or African American Beneficiaries | 30 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1001 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 97 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1686 |