| National Provider Identifier [NPI]: | 1023193430 |
| Last Name Of The Provider | MARTINEZ |
| First Name Of The Provider | EVANGELINA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2930 2ND AVE |
| Street Address 2 Of The Provider | 200 |
| City Of The Provider | MARINA |
| Zip Code Of The Provider | 939336244 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 1949 |
| Number Of Medicare Beneficiaries | 522 |
| Total Submitted Charge Amount | 339265.4 |
| Total Medicare Allowed Amount | 175888.97 |
| Total Medicare Payment Amount | 120252.3 |
| Total Medicare Standardized Payment Amount | 117828.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 155 |
| Number Of Medicare Beneficiaries With Drug Services | 141 |
| Total Drug Submitted ChargeAmount | 5886 |
| Total Drug Medicare AllowedAmount | 3258.87 |
| Total Drug Medicare PaymentAmount | 3184.68 |
| Total Drug Medicare Standardized Payment Amount | 3184.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 1794 |
| Number Of Medicare Beneficiaries With Medical Services | 522 |
| Total Medical Submitted Charge Amount | 333379.4 |
| Total Medical Medicare Allowed Amount | 172630.1 |
| Total Medical Medicare Payment Amount | 117067.62 |
| Total Medical Medicare Standardized Payment Amount | 114643.44 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 293 |
| Number Of Beneficiaries Age 75 to 84 | 138 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 438 |
| Number Of Male Beneficiaries | 84 |
| Number Of Non Hispanic White Beneficiaries | 388 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 68 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 465 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8778 |