| National Provider Identifier [NPI]: | 1225084189 |
| Last Name Of The Provider | MONTES |
| First Name Of The Provider | HUGO |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11375 CORTEZ BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROOKSVILLE |
| Zip Code Of The Provider | 346135409 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 233 |
| Number Of Services | 12699 |
| Number Of Medicare Beneficiaries | 6127 |
| Total Submitted Charge Amount | 2102866 |
| Total Medicare Allowed Amount | 403098.49 |
| Total Medicare Payment Amount | 307919.87 |
| Total Medicare Standardized Payment Amount | 308720.51 |
| 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 | 233 |
| Number Of Medical Services | 12699 |
| Number Of Medicare Beneficiaries With Medical Services | 6127 |
| Total Medical Submitted Charge Amount | 2102866 |
| Total Medical Medicare Allowed Amount | 403098.49 |
| Total Medical Medicare Payment Amount | 307919.87 |
| Total Medical Medicare Standardized Payment Amount | 308720.51 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 762 |
| Number Of Beneficiaries Age 65 to 74 | 2029 |
| Number Of Beneficiaries Age 75 to 84 | 1992 |
| Number Of Beneficiaries Age Greater 84 | 1344 |
| Number Of Female Beneficiaries | 3514 |
| Number Of Male Beneficiaries | 2613 |
| Number Of Non Hispanic White Beneficiaries | 5261 |
| Number Of Black or African American Beneficiaries | 204 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 581 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4892 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1235 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8214 |