National Provider Identifier [NPI]: |
1245238948 |
Last Name Of The Provider |
MARTIN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12180 28TH ST N |
Street Address 2 Of The Provider |
|
City Of The Provider |
ST PETERSBURG |
Zip Code Of The Provider |
337161820 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
7342 |
Number Of Medicare Beneficiaries |
1825 |
Total Submitted Charge Amount |
563793 |
Total Medicare Allowed Amount |
484079.03 |
Total Medicare Payment Amount |
365412.31 |
Total Medicare Standardized Payment Amount |
364747.34 |
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 |
13 |
Number Of Medical Services |
7342 |
Number Of Medicare Beneficiaries With Medical Services |
1825 |
Total Medical Submitted Charge Amount |
563793 |
Total Medical Medicare Allowed Amount |
484079.03 |
Total Medical Medicare Payment Amount |
365412.31 |
Total Medical Medicare Standardized Payment Amount |
364747.34 |
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
222 |
Number Of Beneficiaries Age 65 to 74 |
232 |
Number Of Beneficiaries Age 75 to 84 |
470 |
Number Of Beneficiaries Age Greater 84 |
901 |
Number Of Female Beneficiaries |
1226 |
Number Of Male Beneficiaries |
599 |
Number Of Non Hispanic White Beneficiaries |
1614 |
Number Of Black or African American Beneficiaries |
143 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
45 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
975 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
850 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
68 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.8762 |