| National Provider Identifier [NPI]: | 1972790186 |
| Last Name Of The Provider | MONTEITH |
| First Name Of The Provider | TESHAMAE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1150 NW 14TH ST STE 609 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MIAMI |
| Zip Code Of The Provider | 331362117 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 7979 |
| Number Of Medicare Beneficiaries | 90 |
| Total Submitted Charge Amount | 149464 |
| Total Medicare Allowed Amount | 67496.9 |
| Total Medicare Payment Amount | 51715.36 |
| Total Medicare Standardized Payment Amount | 49829.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 7800 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 78000 |
| Total Drug Medicare AllowedAmount | 42946 |
| Total Drug Medicare PaymentAmount | 33669.73 |
| Total Drug Medicare Standardized Payment Amount | 33669.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 179 |
| Number Of Medicare Beneficiaries With Medical Services | 90 |
| Total Medical Submitted Charge Amount | 71464 |
| Total Medical Medicare Allowed Amount | 24550.9 |
| Total Medical Medicare Payment Amount | 18045.63 |
| Total Medical Medicare Standardized Payment Amount | 16159.29 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 35 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 61 |
| Number Of Male Beneficiaries | 29 |
| Number Of Non Hispanic White Beneficiaries | 44 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 46 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 59 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6575 |