| National Provider Identifier [NPI]: | 1316981988 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 593 EDDY ST |
| Street Address 2 Of The Provider | APC 7 |
| City Of The Provider | PROVIDENCE |
| Zip Code Of The Provider | 029034923 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 1887 |
| Number Of Medicare Beneficiaries | 478 |
| Total Submitted Charge Amount | 215933 |
| Total Medicare Allowed Amount | 135543.2 |
| Total Medicare Payment Amount | 102320.36 |
| Total Medicare Standardized Payment Amount | 100825.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 822 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 23064 |
| Total Drug Medicare AllowedAmount | 21535.88 |
| Total Drug Medicare PaymentAmount | 16917.28 |
| Total Drug Medicare Standardized Payment Amount | 16917.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 1065 |
| Number Of Medicare Beneficiaries With Medical Services | 478 |
| Total Medical Submitted Charge Amount | 192869 |
| Total Medical Medicare Allowed Amount | 114007.32 |
| Total Medical Medicare Payment Amount | 85403.08 |
| Total Medical Medicare Standardized Payment Amount | 83908.12 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 118 |
| Number Of Beneficiaries Age 65 to 74 | 164 |
| Number Of Beneficiaries Age 75 to 84 | 139 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 261 |
| Number Of Male Beneficiaries | 217 |
| Number Of Non Hispanic White Beneficiaries | 400 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 306 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 172 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 26 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 51 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.1722 |