| National Provider Identifier [NPI]: | 1861481731 |
| Last Name Of The Provider | SNOW |
| First Name Of The Provider | MONTY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1125 E SOUTHERN AVE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | MESA |
| Zip Code Of The Provider | 852045045 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 5378 |
| Number Of Medicare Beneficiaries | 1090 |
| Total Submitted Charge Amount | 4064076.84 |
| Total Medicare Allowed Amount | 1647241.29 |
| Total Medicare Payment Amount | 1278501.39 |
| Total Medicare Standardized Payment Amount | 1279703.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1257 |
| Number Of Medicare Beneficiaries With Drug Services | 340 |
| Total Drug Submitted ChargeAmount | 7062.16 |
| Total Drug Medicare AllowedAmount | 965.7 |
| Total Drug Medicare PaymentAmount | 757.59 |
| Total Drug Medicare Standardized Payment Amount | 757.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 113 |
| Number Of Medical Services | 4121 |
| Number Of Medicare Beneficiaries With Medical Services | 1090 |
| Total Medical Submitted Charge Amount | 4057014.68 |
| Total Medical Medicare Allowed Amount | 1646275.59 |
| Total Medical Medicare Payment Amount | 1277743.8 |
| Total Medical Medicare Standardized Payment Amount | 1278946.21 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 330 |
| Number Of Beneficiaries Age 65 to 74 | 364 |
| Number Of Beneficiaries Age 75 to 84 | 243 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 564 |
| Number Of Male Beneficiaries | 526 |
| Number Of Non Hispanic White Beneficiaries | 644 |
| Number Of Black or African American Beneficiaries | 62 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 94 |
| Number Of American Indian Alaska Native Beneficiaries | 268 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 726 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 364 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 5.1698 |