| National Provider Identifier [NPI]: | 1306832597 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | TRACY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 725 AMERICAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WAUKESHA |
| Zip Code Of The Provider | 531885031 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 6019 |
| Number Of Medicare Beneficiaries | 2145 |
| Total Submitted Charge Amount | 773866 |
| Total Medicare Allowed Amount | 137478.88 |
| Total Medicare Payment Amount | 107033.55 |
| Total Medicare Standardized Payment Amount | 111993.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2404 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 13988 |
| Total Drug Medicare AllowedAmount | 504.93 |
| Total Drug Medicare PaymentAmount | 395.81 |
| Total Drug Medicare Standardized Payment Amount | 395.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 156 |
| Number Of Medical Services | 3615 |
| Number Of Medicare Beneficiaries With Medical Services | 2145 |
| Total Medical Submitted Charge Amount | 759878 |
| Total Medical Medicare Allowed Amount | 136973.95 |
| Total Medical Medicare Payment Amount | 106637.74 |
| Total Medical Medicare Standardized Payment Amount | 111597.29 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 237 |
| Number Of Beneficiaries Age 65 to 74 | 895 |
| Number Of Beneficiaries Age 75 to 84 | 653 |
| Number Of Beneficiaries Age Greater 84 | 360 |
| Number Of Female Beneficiaries | 1369 |
| Number Of Male Beneficiaries | 776 |
| Number Of Non Hispanic White Beneficiaries | 2039 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1853 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 292 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3885 |