| National Provider Identifier [NPI]: | 1104883693 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 700 E MARSHALL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LONGVIEW |
| Zip Code Of The Provider | 756015580 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 303 |
| Number Of Services | 7977 |
| Number Of Medicare Beneficiaries | 3963 |
| Total Submitted Charge Amount | 1218583 |
| Total Medicare Allowed Amount | 337245.96 |
| Total Medicare Payment Amount | 257236.51 |
| Total Medicare Standardized Payment Amount | 268186.42 |
| 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 | 303 |
| Number Of Medical Services | 7977 |
| Number Of Medicare Beneficiaries With Medical Services | 3963 |
| Total Medical Submitted Charge Amount | 1218583 |
| Total Medical Medicare Allowed Amount | 337245.96 |
| Total Medical Medicare Payment Amount | 257236.51 |
| Total Medical Medicare Standardized Payment Amount | 268186.42 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 900 |
| Number Of Beneficiaries Age 65 to 74 | 1333 |
| Number Of Beneficiaries Age 75 to 84 | 1110 |
| Number Of Beneficiaries Age Greater 84 | 620 |
| Number Of Female Beneficiaries | 2358 |
| Number Of Male Beneficiaries | 1605 |
| Number Of Non Hispanic White Beneficiaries | 2967 |
| Number Of Black or African American Beneficiaries | 874 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 80 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2635 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1328 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.0379 |