| National Provider Identifier [NPI]: | 1770588394 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | RAUL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2910 SAINT MARYS AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HANNIBAL |
| Zip Code Of The Provider | 634013715 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 207 |
| Number Of Services | 8385 |
| Number Of Medicare Beneficiaries | 3740 |
| Total Submitted Charge Amount | 978415 |
| Total Medicare Allowed Amount | 203662.9 |
| Total Medicare Payment Amount | 155583.27 |
| Total Medicare Standardized Payment Amount | 156074.79 |
| 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 | 207 |
| Number Of Medical Services | 8385 |
| Number Of Medicare Beneficiaries With Medical Services | 3740 |
| Total Medical Submitted Charge Amount | 978415 |
| Total Medical Medicare Allowed Amount | 203662.9 |
| Total Medical Medicare Payment Amount | 155583.27 |
| Total Medical Medicare Standardized Payment Amount | 156074.79 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 471 |
| Number Of Beneficiaries Age 65 to 74 | 1248 |
| Number Of Beneficiaries Age 75 to 84 | 1278 |
| Number Of Beneficiaries Age Greater 84 | 743 |
| Number Of Female Beneficiaries | 2055 |
| Number Of Male Beneficiaries | 1685 |
| Number Of Non Hispanic White Beneficiaries | 3386 |
| Number Of Black or African American Beneficiaries | 149 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 150 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2988 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 752 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8137 |