| National Provider Identifier [NPI]: | 1134332539 |
| Last Name Of The Provider | MONTIEL |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 554 MCQUEEN SMITH RD N |
| Street Address 2 Of The Provider | |
| City Of The Provider | PRATTVILLE |
| Zip Code Of The Provider | 360665558 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 248 |
| Number Of Medicare Beneficiaries | 47 |
| Total Submitted Charge Amount | 33290 |
| Total Medicare Allowed Amount | 18629.18 |
| Total Medicare Payment Amount | 14267.54 |
| Total Medicare Standardized Payment Amount | 15717.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1110 |
| Total Drug Medicare AllowedAmount | 150.27 |
| Total Drug Medicare PaymentAmount | 117.8 |
| Total Drug Medicare Standardized Payment Amount | 117.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 219 |
| Number Of Medicare Beneficiaries With Medical Services | 47 |
| Total Medical Submitted Charge Amount | 32180 |
| Total Medical Medicare Allowed Amount | 18478.91 |
| Total Medical Medicare Payment Amount | 14149.74 |
| Total Medical Medicare Standardized Payment Amount | 15599.63 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 22 |
| Number Of Male Beneficiaries | 25 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 35 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 51 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.9531 |