| National Provider Identifier [NPI]: | 1023063922 |
| Last Name Of The Provider | MENDIOLA |
| First Name Of The Provider | CARMELO |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2202 JORDAN ROAD SW |
| Street Address 2 Of The Provider | SUITE 500 |
| City Of The Provider | FORT PAYNE |
| Zip Code Of The Provider | 359683688 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 9055 |
| Number Of Medicare Beneficiaries | 1585 |
| Total Submitted Charge Amount | 632786 |
| Total Medicare Allowed Amount | 450976.75 |
| Total Medicare Payment Amount | 334668.99 |
| Total Medicare Standardized Payment Amount | 369522.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 2006 |
| Number Of Medicare Beneficiaries With Drug Services | 406 |
| Total Drug Submitted ChargeAmount | 35624 |
| Total Drug Medicare AllowedAmount | 29426.79 |
| Total Drug Medicare PaymentAmount | 24500.67 |
| Total Drug Medicare Standardized Payment Amount | 24500.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 7049 |
| Number Of Medicare Beneficiaries With Medical Services | 1585 |
| Total Medical Submitted Charge Amount | 597162 |
| Total Medical Medicare Allowed Amount | 421549.96 |
| Total Medical Medicare Payment Amount | 310168.32 |
| Total Medical Medicare Standardized Payment Amount | 345021.76 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 315 |
| Number Of Beneficiaries Age 65 to 74 | 584 |
| Number Of Beneficiaries Age 75 to 84 | 463 |
| Number Of Beneficiaries Age Greater 84 | 223 |
| Number Of Female Beneficiaries | 905 |
| Number Of Male Beneficiaries | 680 |
| Number Of Non Hispanic White Beneficiaries | 1533 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1102 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 483 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4548 |