National Provider Identifier [NPI]: |
1912147521 |
Last Name Of The Provider |
MENDEZ |
First Name Of The Provider |
EDUARDO |
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 |
9618 PINES BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PEMBROKE PINES |
Zip Code Of The Provider |
330246240 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
1521 |
Number Of Medicare Beneficiaries |
330 |
Total Submitted Charge Amount |
197304 |
Total Medicare Allowed Amount |
107250.27 |
Total Medicare Payment Amount |
78899.34 |
Total Medicare Standardized Payment Amount |
76245.27 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
22 |
Number Of Medicare Beneficiaries With Drug Services |
20 |
Total Drug Submitted ChargeAmount |
364 |
Total Drug Medicare AllowedAmount |
104.54 |
Total Drug Medicare PaymentAmount |
81.96 |
Total Drug Medicare Standardized Payment Amount |
81.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
48 |
Number Of Medical Services |
1499 |
Number Of Medicare Beneficiaries With Medical Services |
330 |
Total Medical Submitted Charge Amount |
196940 |
Total Medical Medicare Allowed Amount |
107145.73 |
Total Medical Medicare Payment Amount |
78817.38 |
Total Medical Medicare Standardized Payment Amount |
76163.31 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
108 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
190 |
Number Of Male Beneficiaries |
140 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
290 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
12 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
318 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
43 |
Percent Of With Depression |
55 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.4964 |