| National Provider Identifier [NPI]: | 1841290293 |
| Last Name Of The Provider | MONTZKA |
| First Name Of The Provider | DAN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10730 US HIGHWAY 19 |
| Street Address 2 Of The Provider | STE 7 |
| City Of The Provider | PORT RICHEY |
| Zip Code Of The Provider | 346682885 |
| 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 | 36 |
| Number Of Services | 5572 |
| Number Of Medicare Beneficiaries | 963 |
| Total Submitted Charge Amount | 912726.44 |
| Total Medicare Allowed Amount | 564772.92 |
| Total Medicare Payment Amount | 423443.06 |
| Total Medicare Standardized Payment Amount | 426347.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 201 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 82009.47 |
| Total Drug Medicare AllowedAmount | 39922.28 |
| Total Drug Medicare PaymentAmount | 31299.08 |
| Total Drug Medicare Standardized Payment Amount | 31299.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 5371 |
| Number Of Medicare Beneficiaries With Medical Services | 963 |
| Total Medical Submitted Charge Amount | 830716.97 |
| Total Medical Medicare Allowed Amount | 524850.64 |
| Total Medical Medicare Payment Amount | 392143.98 |
| Total Medical Medicare Standardized Payment Amount | 395048.01 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 287 |
| Number Of Beneficiaries Age 75 to 84 | 348 |
| Number Of Beneficiaries Age Greater 84 | 279 |
| Number Of Female Beneficiaries | 568 |
| Number Of Male Beneficiaries | 395 |
| Number Of Non Hispanic White Beneficiaries | 874 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 898 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4381 |