| National Provider Identifier [NPI]: | 1750434031 |
| Last Name Of The Provider | MONTEZA |
| First Name Of The Provider | FRANCO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8720 14TH AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | SEATTLE |
| Zip Code Of The Provider | 981084807 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 261 |
| Number Of Medicare Beneficiaries | 68 |
| Total Submitted Charge Amount | 5525.79 |
| Total Medicare Allowed Amount | 3987.11 |
| Total Medicare Payment Amount | 3455.74 |
| Total Medicare Standardized Payment Amount | 3528.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 678.19 |
| Total Drug Medicare AllowedAmount | 664.43 |
| Total Drug Medicare PaymentAmount | 649.99 |
| Total Drug Medicare Standardized Payment Amount | 649.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 237 |
| Number Of Medicare Beneficiaries With Medical Services | 67 |
| Total Medical Submitted Charge Amount | 4847.6 |
| Total Medical Medicare Allowed Amount | 3322.68 |
| Total Medical Medicare Payment Amount | 2805.75 |
| Total Medical Medicare Standardized Payment Amount | 2878.98 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 22 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 32 |
| Number Of Male Beneficiaries | 36 |
| Number Of Non Hispanic White Beneficiaries | 38 |
| 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 | 25 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 19 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 16 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.244 |