National Provider Identifier [NPI]: |
1649387622 |
Last Name Of The Provider |
MONTE |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 RIDGEWAY ST |
Street Address 2 Of The Provider |
STE 2 |
City Of The Provider |
HOT SPRINGS |
Zip Code Of The Provider |
719017145 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
3083 |
Number Of Medicare Beneficiaries |
893 |
Total Submitted Charge Amount |
283672 |
Total Medicare Allowed Amount |
149273.82 |
Total Medicare Payment Amount |
105181.35 |
Total Medicare Standardized Payment Amount |
117800.32 |
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 |
64 |
Number Of Medical Services |
3083 |
Number Of Medicare Beneficiaries With Medical Services |
893 |
Total Medical Submitted Charge Amount |
283672 |
Total Medical Medicare Allowed Amount |
149273.82 |
Total Medical Medicare Payment Amount |
105181.35 |
Total Medical Medicare Standardized Payment Amount |
117800.32 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
107 |
Number Of Beneficiaries Age 65 to 74 |
314 |
Number Of Beneficiaries Age 75 to 84 |
320 |
Number Of Beneficiaries Age Greater 84 |
152 |
Number Of Female Beneficiaries |
475 |
Number Of Male Beneficiaries |
418 |
Number Of Non Hispanic White Beneficiaries |
855 |
Number Of Black or African American Beneficiaries |
24 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
751 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
142 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1267 |