| National Provider Identifier [NPI]: | 1194727834 |
| Last Name Of The Provider | MARTINEZ |
| First Name Of The Provider | EDUARDO |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1720 COOPER FOSTER PARK RD W |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | LORAIN |
| Zip Code Of The Provider | 440534200 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 181 |
| Number Of Services | 5782 |
| Number Of Medicare Beneficiaries | 3305 |
| Total Submitted Charge Amount | 521665 |
| Total Medicare Allowed Amount | 161858.12 |
| Total Medicare Payment Amount | 123122.43 |
| Total Medicare Standardized Payment Amount | 126849.48 |
| 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 | 181 |
| Number Of Medical Services | 5782 |
| Number Of Medicare Beneficiaries With Medical Services | 3305 |
| Total Medical Submitted Charge Amount | 521665 |
| Total Medical Medicare Allowed Amount | 161858.12 |
| Total Medical Medicare Payment Amount | 123122.43 |
| Total Medical Medicare Standardized Payment Amount | 126849.48 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 640 |
| Number Of Beneficiaries Age 65 to 74 | 1226 |
| Number Of Beneficiaries Age 75 to 84 | 952 |
| Number Of Beneficiaries Age Greater 84 | 487 |
| Number Of Female Beneficiaries | 2069 |
| Number Of Male Beneficiaries | 1236 |
| Number Of Non Hispanic White Beneficiaries | 2934 |
| Number Of Black or African American Beneficiaries | 206 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 112 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2472 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 833 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7383 |