| National Provider Identifier [NPI]: | 1043247422 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1201 MICHIGAN AVE., #390 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOGANSPORT |
| Zip Code Of The Provider | 46947 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 154 |
| Number Of Services | 4923 |
| Number Of Medicare Beneficiaries | 2221 |
| Total Submitted Charge Amount | 528610 |
| Total Medicare Allowed Amount | 123507.13 |
| Total Medicare Payment Amount | 98074.13 |
| Total Medicare Standardized Payment Amount | 102988.91 |
| 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 | 154 |
| Number Of Medical Services | 4923 |
| Number Of Medicare Beneficiaries With Medical Services | 2221 |
| Total Medical Submitted Charge Amount | 528610 |
| Total Medical Medicare Allowed Amount | 123507.13 |
| Total Medical Medicare Payment Amount | 98074.13 |
| Total Medical Medicare Standardized Payment Amount | 102988.91 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 402 |
| Number Of Beneficiaries Age 65 to 74 | 773 |
| Number Of Beneficiaries Age 75 to 84 | 655 |
| Number Of Beneficiaries Age Greater 84 | 391 |
| Number Of Female Beneficiaries | 1469 |
| Number Of Male Beneficiaries | 752 |
| Number Of Non Hispanic White Beneficiaries | 2142 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1669 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 552 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.33 |