| National Provider Identifier [NPI]: | 1568435204 |
| Last Name Of The Provider | MONTES |
| First Name Of The Provider | IGNACIO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4003 KRESGE WAY |
| Street Address 2 Of The Provider | STE 500 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 40207 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 1692 |
| Number Of Medicare Beneficiaries | 502 |
| Total Submitted Charge Amount | 284482 |
| Total Medicare Allowed Amount | 132760.75 |
| Total Medicare Payment Amount | 97921.83 |
| Total Medicare Standardized Payment Amount | 103221.92 |
| 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 | 20 |
| Number Of Medical Services | 1692 |
| Number Of Medicare Beneficiaries With Medical Services | 502 |
| Total Medical Submitted Charge Amount | 284482 |
| Total Medical Medicare Allowed Amount | 132760.75 |
| Total Medical Medicare Payment Amount | 97921.83 |
| Total Medical Medicare Standardized Payment Amount | 103221.92 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 195 |
| Number Of Beneficiaries Age 75 to 84 | 181 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 294 |
| Number Of Male Beneficiaries | 208 |
| Number Of Non Hispanic White Beneficiaries | 456 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 464 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 46 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.8236 |