| National Provider Identifier [NPI]: | 1861618993 |
| Last Name Of The Provider | MONTGOMERY |
| First Name Of The Provider | BHANU |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | P.T. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2767 SILVER CREEK RD |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | BULLHEAD CITY |
| Zip Code Of The Provider | 864428227 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Therapist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 13927 |
| Number Of Medicare Beneficiaries | 346 |
| Total Submitted Charge Amount | 596225 |
| Total Medicare Allowed Amount | 313473.75 |
| Total Medicare Payment Amount | 238324.82 |
| Total Medicare Standardized Payment Amount | 227246.26 |
| 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 | 24 |
| Number Of Medical Services | 13927 |
| Number Of Medicare Beneficiaries With Medical Services | 346 |
| Total Medical Submitted Charge Amount | 596225 |
| Total Medical Medicare Allowed Amount | 313473.75 |
| Total Medical Medicare Payment Amount | 238324.82 |
| Total Medical Medicare Standardized Payment Amount | 227246.26 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 163 |
| Number Of Beneficiaries Age 75 to 84 | 112 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 224 |
| Number Of Male Beneficiaries | 122 |
| Number Of Non Hispanic White Beneficiaries | 309 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 313 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.2346 |