| National Provider Identifier [NPI]: | 1144228669 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | DEBORAH |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | FAMILY NURSE PRACT. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7235 HACKS CROSS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | OLIVE BRANCH |
| Zip Code Of The Provider | 386544213 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 769 |
| Number Of Medicare Beneficiaries | 211 |
| Total Submitted Charge Amount | 109726.21 |
| Total Medicare Allowed Amount | 32532.84 |
| Total Medicare Payment Amount | 20988.49 |
| Total Medicare Standardized Payment Amount | 28236.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 103 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 2507 |
| Total Drug Medicare AllowedAmount | 703.87 |
| Total Drug Medicare PaymentAmount | 545.72 |
| Total Drug Medicare Standardized Payment Amount | 545.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 666 |
| Number Of Medicare Beneficiaries With Medical Services | 211 |
| Total Medical Submitted Charge Amount | 107219.21 |
| Total Medical Medicare Allowed Amount | 31828.97 |
| Total Medical Medicare Payment Amount | 20442.77 |
| Total Medical Medicare Standardized Payment Amount | 27691.12 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 112 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 128 |
| Number Of Male Beneficiaries | 83 |
| Number Of Non Hispanic White Beneficiaries | 149 |
| 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 | 161 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 3.2716 |