| National Provider Identifier [NPI]: | 1477688612 |
| Last Name Of The Provider | AMANTIA |
| First Name Of The Provider | MONICA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11271 VENTURA BLVD |
| Street Address 2 Of The Provider | #470 |
| City Of The Provider | STUDIO CITY |
| Zip Code Of The Provider | 916043136 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 232 |
| Number Of Services | 10501 |
| Number Of Medicare Beneficiaries | 3443 |
| Total Submitted Charge Amount | 963668 |
| Total Medicare Allowed Amount | 357881.92 |
| Total Medicare Payment Amount | 290085.89 |
| Total Medicare Standardized Payment Amount | 266559.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3120 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 3120 |
| Total Drug Medicare AllowedAmount | 664.34 |
| Total Drug Medicare PaymentAmount | 489.32 |
| Total Drug Medicare Standardized Payment Amount | 489.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 230 |
| Number Of Medical Services | 7381 |
| Number Of Medicare Beneficiaries With Medical Services | 3443 |
| Total Medical Submitted Charge Amount | 960548 |
| Total Medical Medicare Allowed Amount | 357217.58 |
| Total Medical Medicare Payment Amount | 289596.57 |
| Total Medical Medicare Standardized Payment Amount | 266070.22 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 222 |
| Number Of Beneficiaries Age 65 to 74 | 1266 |
| Number Of Beneficiaries Age 75 to 84 | 1085 |
| Number Of Beneficiaries Age Greater 84 | 870 |
| Number Of Female Beneficiaries | 2200 |
| Number Of Male Beneficiaries | 1243 |
| Number Of Non Hispanic White Beneficiaries | 2986 |
| Number Of Black or African American Beneficiaries | 44 |
| Number Of AsianPacific Islander Beneficiaries | 135 |
| Number Of Hispanic Beneficiaries | 213 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 65 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2988 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 455 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6341 |