| National Provider Identifier [NPI]: | 1922100080 |
| Last Name Of The Provider | MONTGOMERY |
| First Name Of The Provider | DAN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 830 MEDICAL CT E |
| Street Address 2 Of The Provider | |
| City Of The Provider | INVERNESS |
| Zip Code Of The Provider | 344524612 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 7251 |
| Number Of Medicare Beneficiaries | 2566 |
| Total Submitted Charge Amount | 1733217.06 |
| Total Medicare Allowed Amount | 941017.17 |
| Total Medicare Payment Amount | 690345.28 |
| Total Medicare Standardized Payment Amount | 689111.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 2050 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 12935.5 |
| Total Drug Medicare AllowedAmount | 11256.2 |
| Total Drug Medicare PaymentAmount | 8679.25 |
| Total Drug Medicare Standardized Payment Amount | 8679.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 5201 |
| Number Of Medicare Beneficiaries With Medical Services | 2566 |
| Total Medical Submitted Charge Amount | 1720281.56 |
| Total Medical Medicare Allowed Amount | 929760.97 |
| Total Medical Medicare Payment Amount | 681666.03 |
| Total Medical Medicare Standardized Payment Amount | 680431.88 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 922 |
| Number Of Beneficiaries Age 75 to 84 | 1084 |
| Number Of Beneficiaries Age Greater 84 | 490 |
| Number Of Female Beneficiaries | 1533 |
| Number Of Male Beneficiaries | 1033 |
| Number Of Non Hispanic White Beneficiaries | 2424 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2434 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 132 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0643 |