| National Provider Identifier [NPI]: | 1295733723 |
| Last Name Of The Provider | MONTGOMERY |
| First Name Of The Provider | STUART |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5050 NE HOYT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972132983 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 531 |
| Number Of Medicare Beneficiaries | 129 |
| Total Submitted Charge Amount | 189240.2 |
| Total Medicare Allowed Amount | 58355.14 |
| Total Medicare Payment Amount | 43460.3 |
| Total Medicare Standardized Payment Amount | 44766.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 175 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 1750 |
| Total Drug Medicare AllowedAmount | 1000.99 |
| Total Drug Medicare PaymentAmount | 726.16 |
| Total Drug Medicare Standardized Payment Amount | 726.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 356 |
| Number Of Medicare Beneficiaries With Medical Services | 129 |
| Total Medical Submitted Charge Amount | 187490.2 |
| Total Medical Medicare Allowed Amount | 57354.15 |
| Total Medical Medicare Payment Amount | 42734.14 |
| Total Medical Medicare Standardized Payment Amount | 44040.59 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 58 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 77 |
| Number Of Male Beneficiaries | 52 |
| Number Of Non Hispanic White Beneficiaries | 112 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 108 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1748 |