| National Provider Identifier [NPI]: | 1164403648 |
| Last Name Of The Provider | MONTGOMERY |
| First Name Of The Provider | MICHAEL |
| 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 | 6250 US HIGHWAY 83 |
| Street Address 2 Of The Provider | ABILENE REGIONAL MEDICAL CENTER RADIOLOGY DEPARTMENT |
| City Of The Provider | ABILENE |
| Zip Code Of The Provider | 796065215 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 222 |
| Number Of Services | 10424 |
| Number Of Medicare Beneficiaries | 4439 |
| Total Submitted Charge Amount | 849599 |
| Total Medicare Allowed Amount | 264063.95 |
| Total Medicare Payment Amount | 208242.14 |
| Total Medicare Standardized Payment Amount | 219778.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 222 |
| Number Of Medical Services | 10424 |
| Number Of Medicare Beneficiaries With Medical Services | 4439 |
| Total Medical Submitted Charge Amount | 849599 |
| Total Medical Medicare Allowed Amount | 264063.95 |
| Total Medical Medicare Payment Amount | 208242.14 |
| Total Medical Medicare Standardized Payment Amount | 219778.08 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 610 |
| Number Of Beneficiaries Age 65 to 74 | 1846 |
| Number Of Beneficiaries Age 75 to 84 | 1392 |
| Number Of Beneficiaries Age Greater 84 | 591 |
| Number Of Female Beneficiaries | 2908 |
| Number Of Male Beneficiaries | 1531 |
| Number Of Non Hispanic White Beneficiaries | 3889 |
| Number Of Black or African American Beneficiaries | 148 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 349 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3565 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 874 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3241 |