| National Provider Identifier [NPI]: | 1669512836 |
| Last Name Of The Provider | MASKA |
| First Name Of The Provider | MONTE |
| 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 | 2711 S MEADOWBROOK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 658075924 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 1075 |
| Number Of Medicare Beneficiaries | 158 |
| Total Submitted Charge Amount | 97059 |
| Total Medicare Allowed Amount | 61937.7 |
| Total Medicare Payment Amount | 45044.26 |
| Total Medicare Standardized Payment Amount | 49331.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 184 |
| Number Of Medicare Beneficiaries With Drug Services | 90 |
| Total Drug Submitted ChargeAmount | 5006 |
| Total Drug Medicare AllowedAmount | 3164.88 |
| Total Drug Medicare PaymentAmount | 3020.88 |
| Total Drug Medicare Standardized Payment Amount | 3020.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 891 |
| Number Of Medicare Beneficiaries With Medical Services | 158 |
| Total Medical Submitted Charge Amount | 92053 |
| Total Medical Medicare Allowed Amount | 58772.82 |
| Total Medical Medicare Payment Amount | 42023.38 |
| Total Medical Medicare Standardized Payment Amount | 46310.48 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 84 |
| Number Of Male Beneficiaries | 74 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 143 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8869 |