| National Provider Identifier [NPI]: | 1861459661 |
| Last Name Of The Provider | MONTGOMERY |
| First Name Of The Provider | DANIELE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9 SAN BARTOLA DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST AUGUSTINE |
| Zip Code Of The Provider | 320865767 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 129 |
| Number Of Services | 161034 |
| Number Of Medicare Beneficiaries | 738 |
| Total Submitted Charge Amount | 6313571 |
| Total Medicare Allowed Amount | 2365304.27 |
| Total Medicare Payment Amount | 1848421.16 |
| Total Medicare Standardized Payment Amount | 1833919.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 75 |
| Number Of Drug Services | 152962 |
| Number Of Medicare Beneficiaries With Drug Services | 224 |
| Total Drug Submitted ChargeAmount | 5480680 |
| Total Drug Medicare AllowedAmount | 1976578.64 |
| Total Drug Medicare PaymentAmount | 1546428.53 |
| Total Drug Medicare Standardized Payment Amount | 1546428.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 8072 |
| Number Of Medicare Beneficiaries With Medical Services | 738 |
| Total Medical Submitted Charge Amount | 832891 |
| Total Medical Medicare Allowed Amount | 388725.63 |
| Total Medical Medicare Payment Amount | 301992.63 |
| Total Medical Medicare Standardized Payment Amount | 287491.12 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 297 |
| Number Of Beneficiaries Age 75 to 84 | 230 |
| Number Of Beneficiaries Age Greater 84 | 136 |
| Number Of Female Beneficiaries | 452 |
| Number Of Male Beneficiaries | 286 |
| Number Of Non Hispanic White Beneficiaries | 644 |
| Number Of Black or African American Beneficiaries | 63 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 611 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 44 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.1023 |