| National Provider Identifier [NPI]: | 1942415369 |
| Last Name Of The Provider | MARTUCCI |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2121 E HARMONY RD |
| Street Address 2 Of The Provider | # 350 |
| City Of The Provider | FORT COLLINS |
| Zip Code Of The Provider | 805283400 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 5739 |
| Number Of Medicare Beneficiaries | 225 |
| Total Submitted Charge Amount | 192796 |
| Total Medicare Allowed Amount | 120777.62 |
| Total Medicare Payment Amount | 91793.62 |
| Total Medicare Standardized Payment Amount | 85945.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1663 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 58300 |
| Total Drug Medicare AllowedAmount | 44483.23 |
| Total Drug Medicare PaymentAmount | 34940.98 |
| Total Drug Medicare Standardized Payment Amount | 34940.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 4076 |
| Number Of Medicare Beneficiaries With Medical Services | 225 |
| Total Medical Submitted Charge Amount | 134496 |
| Total Medical Medicare Allowed Amount | 76294.39 |
| Total Medical Medicare Payment Amount | 56852.64 |
| Total Medical Medicare Standardized Payment Amount | 51004.33 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 112 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 132 |
| Number Of Male Beneficiaries | 93 |
| Number Of Non Hispanic White Beneficiaries | 197 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 193 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 36 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1652 |