| National Provider Identifier [NPI]: | 1508899402 |
| Last Name Of The Provider | MONTSDEOCA |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4343 SUN N LAKE BLVD |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | SEBRING |
| Zip Code Of The Provider | 338722162 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 8304 |
| Number Of Medicare Beneficiaries | 1174 |
| Total Submitted Charge Amount | 828284.61 |
| Total Medicare Allowed Amount | 549930.86 |
| Total Medicare Payment Amount | 411188.39 |
| Total Medicare Standardized Payment Amount | 419127.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 3805 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 341754.6 |
| Total Drug Medicare AllowedAmount | 167417.96 |
| Total Drug Medicare PaymentAmount | 131173.92 |
| Total Drug Medicare Standardized Payment Amount | 131173.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 4499 |
| Number Of Medicare Beneficiaries With Medical Services | 1174 |
| Total Medical Submitted Charge Amount | 486530.01 |
| Total Medical Medicare Allowed Amount | 382512.9 |
| Total Medical Medicare Payment Amount | 280014.47 |
| Total Medical Medicare Standardized Payment Amount | 287953.34 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 261 |
| Number Of Beneficiaries Age 75 to 84 | 394 |
| Number Of Beneficiaries Age Greater 84 | 422 |
| Number Of Female Beneficiaries | 801 |
| Number Of Male Beneficiaries | 373 |
| Number Of Non Hispanic White Beneficiaries | 1070 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 776 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 398 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 49 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 52 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 24 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.0954 |