| National Provider Identifier [NPI]: | 1659357234 |
| Last Name Of The Provider | MONTEMAYOR |
| First Name Of The Provider | GERTRUDES |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 251 TURN PIKE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FOLSOM |
| Zip Code Of The Provider | 956308098 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 834 |
| Number Of Medicare Beneficiaries | 254 |
| Total Submitted Charge Amount | 125983 |
| Total Medicare Allowed Amount | 73229.36 |
| Total Medicare Payment Amount | 49618.7 |
| Total Medicare Standardized Payment Amount | 48053.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 99 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 4201 |
| Total Drug Medicare AllowedAmount | 2462.1 |
| Total Drug Medicare PaymentAmount | 2407.29 |
| Total Drug Medicare Standardized Payment Amount | 2407.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 735 |
| Number Of Medicare Beneficiaries With Medical Services | 254 |
| Total Medical Submitted Charge Amount | 121782 |
| Total Medical Medicare Allowed Amount | 70767.26 |
| Total Medical Medicare Payment Amount | 47211.41 |
| Total Medical Medicare Standardized Payment Amount | 45645.79 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 156 |
| Number Of Beneficiaries Age 75 to 84 | 61 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 188 |
| Number Of Male Beneficiaries | 66 |
| Number Of Non Hispanic White Beneficiaries | 226 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 237 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 7 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7467 |