| National Provider Identifier [NPI]: | 1598743833 |
| Last Name Of The Provider | ASIS |
| First Name Of The Provider | MARTIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 166 4TH ST E |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551011421 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 4449 |
| Number Of Medicare Beneficiaries | 1872 |
| Total Submitted Charge Amount | 692075.37 |
| Total Medicare Allowed Amount | 187831.41 |
| Total Medicare Payment Amount | 143043.93 |
| Total Medicare Standardized Payment Amount | 148281.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1890 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 9976.1 |
| Total Drug Medicare AllowedAmount | 1192.65 |
| Total Drug Medicare PaymentAmount | 935.11 |
| Total Drug Medicare Standardized Payment Amount | 935.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 2559 |
| Number Of Medicare Beneficiaries With Medical Services | 1865 |
| Total Medical Submitted Charge Amount | 682099.27 |
| Total Medical Medicare Allowed Amount | 186638.76 |
| Total Medical Medicare Payment Amount | 142108.82 |
| Total Medical Medicare Standardized Payment Amount | 147346.49 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 455 |
| Number Of Beneficiaries Age 65 to 74 | 557 |
| Number Of Beneficiaries Age 75 to 84 | 498 |
| Number Of Beneficiaries Age Greater 84 | 362 |
| Number Of Female Beneficiaries | 1062 |
| Number Of Male Beneficiaries | 810 |
| Number Of Non Hispanic White Beneficiaries | 1643 |
| Number Of Black or African American Beneficiaries | 132 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1357 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 515 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.5408 |