| National Provider Identifier [NPI]: | 1053332759 |
| Last Name Of The Provider | MONTALVO |
| First Name Of The Provider | HECTOR |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3020 KINGMAN ST |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | METAIRIE |
| Zip Code Of The Provider | 700066673 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 799 |
| Number Of Medicare Beneficiaries | 170 |
| Total Submitted Charge Amount | 132651.1 |
| Total Medicare Allowed Amount | 63627.48 |
| Total Medicare Payment Amount | 46948.73 |
| Total Medicare Standardized Payment Amount | 47016.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 17 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 882.32 |
| Total Drug Medicare AllowedAmount | 259.62 |
| Total Drug Medicare PaymentAmount | 254.4 |
| Total Drug Medicare Standardized Payment Amount | 254.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 782 |
| Number Of Medicare Beneficiaries With Medical Services | 170 |
| Total Medical Submitted Charge Amount | 131768.78 |
| Total Medical Medicare Allowed Amount | 63367.86 |
| Total Medical Medicare Payment Amount | 46694.33 |
| Total Medical Medicare Standardized Payment Amount | 46762.28 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 99 |
| Number Of Male Beneficiaries | 71 |
| Number Of Non Hispanic White Beneficiaries | 100 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 96 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 73 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 66 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.4752 |