| National Provider Identifier [NPI]: | 1477520435 |
| Last Name Of The Provider | MENDENHALL |
| First Name Of The Provider | MILTON |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 HEALTH PARK BLVD |
| Street Address 2 Of The Provider | ATTN: RADIOLOGY DEPARTMENT |
| City Of The Provider | SAINT AUGUSTINE |
| Zip Code Of The Provider | 320865784 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 195 |
| Number Of Services | 8530 |
| Number Of Medicare Beneficiaries | 4538 |
| Total Submitted Charge Amount | 697602 |
| Total Medicare Allowed Amount | 228002.51 |
| Total Medicare Payment Amount | 177107.91 |
| Total Medicare Standardized Payment Amount | 178119.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 195 |
| Number Of Medical Services | 8530 |
| Number Of Medicare Beneficiaries With Medical Services | 4538 |
| Total Medical Submitted Charge Amount | 697602 |
| Total Medical Medicare Allowed Amount | 228002.51 |
| Total Medical Medicare Payment Amount | 177107.91 |
| Total Medical Medicare Standardized Payment Amount | 178119.2 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 614 |
| Number Of Beneficiaries Age 65 to 74 | 1794 |
| Number Of Beneficiaries Age 75 to 84 | 1384 |
| Number Of Beneficiaries Age Greater 84 | 746 |
| Number Of Female Beneficiaries | 2813 |
| Number Of Male Beneficiaries | 1725 |
| Number Of Non Hispanic White Beneficiaries | 4027 |
| Number Of Black or African American Beneficiaries | 343 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 98 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3658 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 880 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5035 |