National Provider Identifier [NPI]: |
1982628947 |
Last Name Of The Provider |
MONTGOMERY |
First Name Of The Provider |
RIAN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
832 PRINCETON AVE SW |
Street Address 2 Of The Provider |
|
City Of The Provider |
BIRMINGHAM |
Zip Code Of The Provider |
352111320 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
138 |
Number Of Services |
7693 |
Number Of Medicare Beneficiaries |
246 |
Total Submitted Charge Amount |
606356 |
Total Medicare Allowed Amount |
384021.15 |
Total Medicare Payment Amount |
293862.84 |
Total Medicare Standardized Payment Amount |
289402.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
653 |
Number Of Medicare Beneficiaries With Drug Services |
115 |
Total Drug Submitted ChargeAmount |
18343 |
Total Drug Medicare AllowedAmount |
15275.61 |
Total Drug Medicare PaymentAmount |
12741.5 |
Total Drug Medicare Standardized Payment Amount |
12741.5 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
129 |
Number Of Medical Services |
7040 |
Number Of Medicare Beneficiaries With Medical Services |
246 |
Total Medical Submitted Charge Amount |
588013 |
Total Medical Medicare Allowed Amount |
368745.54 |
Total Medical Medicare Payment Amount |
281121.34 |
Total Medical Medicare Standardized Payment Amount |
276660.73 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
106 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
235 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
139 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
107 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6226 |