| National Provider Identifier [NPI]: | 1275627846 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | JUDSON |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 329 WEST 40TH STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | SCOTTSBLUFF |
| Zip Code Of The Provider | 693614634 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 10573 |
| Number Of Medicare Beneficiaries | 1542 |
| Total Submitted Charge Amount | 1836162.1 |
| Total Medicare Allowed Amount | 1197978.84 |
| Total Medicare Payment Amount | 891266.85 |
| Total Medicare Standardized Payment Amount | 939758.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 560 |
| Number Of Medicare Beneficiaries With Drug Services | 65 |
| Total Drug Submitted ChargeAmount | 393447.5 |
| Total Drug Medicare AllowedAmount | 369797.22 |
| Total Drug Medicare PaymentAmount | 288347.36 |
| Total Drug Medicare Standardized Payment Amount | 288347.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 10013 |
| Number Of Medicare Beneficiaries With Medical Services | 1542 |
| Total Medical Submitted Charge Amount | 1442714.6 |
| Total Medical Medicare Allowed Amount | 828181.62 |
| Total Medical Medicare Payment Amount | 602919.49 |
| Total Medical Medicare Standardized Payment Amount | 651411.34 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 448 |
| Number Of Beneficiaries Age 75 to 84 | 615 |
| Number Of Beneficiaries Age Greater 84 | 416 |
| Number Of Female Beneficiaries | 939 |
| Number Of Male Beneficiaries | 603 |
| Number Of Non Hispanic White Beneficiaries | 1415 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 94 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1343 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 199 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1405 |