| National Provider Identifier [NPI]: | 1306887328 |
| Last Name Of The Provider | MENDOZA |
| First Name Of The Provider | LUIS |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5610 W CERMAK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CICERO |
| Zip Code Of The Provider | 60804 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 2441 |
| Number Of Medicare Beneficiaries | 741 |
| Total Submitted Charge Amount | 216486.12 |
| Total Medicare Allowed Amount | 162594.48 |
| Total Medicare Payment Amount | 120061.73 |
| Total Medicare Standardized Payment Amount | 114167.8 |
| Drug Suppress Indicator | * |
| Number Of HCPCS Associated With Drug Services | |
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| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 168 |
| Number Of Beneficiaries Age 75 to 84 | 230 |
| Number Of Beneficiaries Age Greater 84 | 235 |
| Number Of Female Beneficiaries | 479 |
| Number Of Male Beneficiaries | 262 |
| Number Of Non Hispanic White Beneficiaries | 372 |
| Number Of Black or African American Beneficiaries | 184 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 159 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 408 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 333 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 67 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.2445 |