| National Provider Identifier [NPI]: | 1619961976 |
| Last Name Of The Provider | FIALA |
| 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 | 1816 N WASHINGTON ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | TULLAHOMA |
| Zip Code Of The Provider | 373882222 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 137 |
| Number Of Services | 2349 |
| Number Of Medicare Beneficiaries | 427 |
| Total Submitted Charge Amount | 766161.97 |
| Total Medicare Allowed Amount | 213332.72 |
| Total Medicare Payment Amount | 160579.3 |
| Total Medicare Standardized Payment Amount | 176849.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 444 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 17215 |
| Total Drug Medicare AllowedAmount | 4135.19 |
| Total Drug Medicare PaymentAmount | 3119.91 |
| Total Drug Medicare Standardized Payment Amount | 3119.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 135 |
| Number Of Medical Services | 1905 |
| Number Of Medicare Beneficiaries With Medical Services | 427 |
| Total Medical Submitted Charge Amount | 748946.97 |
| Total Medical Medicare Allowed Amount | 209197.53 |
| Total Medical Medicare Payment Amount | 157459.39 |
| Total Medical Medicare Standardized Payment Amount | 173729.59 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 185 |
| Number Of Beneficiaries Age 75 to 84 | 122 |
| Number Of Beneficiaries Age Greater 84 | 49 |
| Number Of Female Beneficiaries | 288 |
| Number Of Male Beneficiaries | 139 |
| Number Of Non Hispanic White Beneficiaries | 413 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 337 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 90 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1586 |