| National Provider Identifier [NPI]: | 1174519516 |
| Last Name Of The Provider | LAMONTAGNE |
| First Name Of The Provider | DENIS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 542 RAILROAD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST JOHNSBURY |
| Zip Code Of The Provider | 058191741 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 2933 |
| Number Of Medicare Beneficiaries | 919 |
| Total Submitted Charge Amount | 210565 |
| Total Medicare Allowed Amount | 157283.96 |
| Total Medicare Payment Amount | 105673.16 |
| Total Medicare Standardized Payment Amount | 106251.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 325 |
| Total Drug Medicare AllowedAmount | 51.29 |
| Total Drug Medicare PaymentAmount | 40.23 |
| Total Drug Medicare Standardized Payment Amount | 40.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 2904 |
| Number Of Medicare Beneficiaries With Medical Services | 918 |
| Total Medical Submitted Charge Amount | 210240 |
| Total Medical Medicare Allowed Amount | 157232.67 |
| Total Medical Medicare Payment Amount | 105632.93 |
| Total Medical Medicare Standardized Payment Amount | 106211.25 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 283 |
| Number Of Beneficiaries Age 75 to 84 | 280 |
| Number Of Beneficiaries Age Greater 84 | 232 |
| Number Of Female Beneficiaries | 567 |
| Number Of Male Beneficiaries | 352 |
| Number Of Non Hispanic White Beneficiaries | 905 |
| 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 | 574 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 345 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.14 |