| National Provider Identifier [NPI]: | 1245250331 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | TAMMY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 233 CLARKSON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ELLISVILLE |
| Zip Code Of The Provider | 630112219 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 475 |
| Number Of Medicare Beneficiaries | 412 |
| Total Submitted Charge Amount | 326018 |
| Total Medicare Allowed Amount | 57208.53 |
| Total Medicare Payment Amount | 42746.79 |
| Total Medicare Standardized Payment Amount | 42972.03 |
| 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 | 23 |
| Number Of Medical Services | 475 |
| Number Of Medicare Beneficiaries With Medical Services | 412 |
| Total Medical Submitted Charge Amount | 326018 |
| Total Medical Medicare Allowed Amount | 57208.53 |
| Total Medical Medicare Payment Amount | 42746.79 |
| Total Medical Medicare Standardized Payment Amount | 42972.03 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 120 |
| Number Of Beneficiaries Age 65 to 74 | 123 |
| Number Of Beneficiaries Age 75 to 84 | 97 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 257 |
| Number Of Male Beneficiaries | 155 |
| Number Of Non Hispanic White Beneficiaries | 307 |
| Number Of Black or African American Beneficiaries | 94 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 252 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 160 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0569 |