National Provider Identifier [NPI]: |
1770507618 |
Last Name Of The Provider |
MARTIN |
First Name Of The Provider |
MELANIE |
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 |
50 E HAMILTON AVE |
Street Address 2 Of The Provider |
# 100 |
City Of The Provider |
CAMPBELL |
Zip Code Of The Provider |
950080259 |
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 |
68 |
Number Of Services |
535 |
Number Of Medicare Beneficiaries |
260 |
Total Submitted Charge Amount |
103109 |
Total Medicare Allowed Amount |
44115.66 |
Total Medicare Payment Amount |
29164.03 |
Total Medicare Standardized Payment Amount |
24506.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
57 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
3452 |
Total Drug Medicare AllowedAmount |
897.22 |
Total Drug Medicare PaymentAmount |
862.57 |
Total Drug Medicare Standardized Payment Amount |
862.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
478 |
Number Of Medicare Beneficiaries With Medical Services |
259 |
Total Medical Submitted Charge Amount |
99657 |
Total Medical Medicare Allowed Amount |
43218.44 |
Total Medical Medicare Payment Amount |
28301.46 |
Total Medical Medicare Standardized Payment Amount |
23643.87 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
16 |
Number Of Beneficiaries Age 65 to 74 |
154 |
Number Of Beneficiaries Age 75 to 84 |
61 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
164 |
Number Of Male Beneficiaries |
96 |
Number Of Non Hispanic White Beneficiaries |
202 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
16 |
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8269 |