| National Provider Identifier [NPI]: | 1124019427 |
| Last Name Of The Provider | MONTOYA |
| First Name Of The Provider | VERNON |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 289 SW STONEGATE TERR |
| Street Address 2 Of The Provider | SUITE #103 |
| City Of The Provider | LAKE CITY |
| Zip Code Of The Provider | 320243457 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Medical Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 53984 |
| Number Of Medicare Beneficiaries | 969 |
| Total Submitted Charge Amount | 2910481.46 |
| Total Medicare Allowed Amount | 992249.46 |
| Total Medicare Payment Amount | 771682.67 |
| Total Medicare Standardized Payment Amount | 771824.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 56 |
| Number Of Drug Services | 43753 |
| Number Of Medicare Beneficiaries With Drug Services | 245 |
| Total Drug Submitted ChargeAmount | 1712858.45 |
| Total Drug Medicare AllowedAmount | 597153.81 |
| Total Drug Medicare PaymentAmount | 467658.4 |
| Total Drug Medicare Standardized Payment Amount | 467658.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 10231 |
| Number Of Medicare Beneficiaries With Medical Services | 969 |
| Total Medical Submitted Charge Amount | 1197623.01 |
| Total Medical Medicare Allowed Amount | 395095.65 |
| Total Medical Medicare Payment Amount | 304024.27 |
| Total Medical Medicare Standardized Payment Amount | 304166.36 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 179 |
| Number Of Beneficiaries Age 65 to 74 | 358 |
| Number Of Beneficiaries Age 75 to 84 | 318 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 610 |
| Number Of Male Beneficiaries | 359 |
| Number Of Non Hispanic White Beneficiaries | 737 |
| Number Of Black or African American Beneficiaries | 204 |
| 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 | 588 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 381 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.0356 |