| National Provider Identifier [NPI]: | 1508863267 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | DAN |
| 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 | 476 HOSPITAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CAMDEN |
| Zip Code Of The Provider | 717014616 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 23031 |
| Number Of Medicare Beneficiaries | 650 |
| Total Submitted Charge Amount | 552523.78 |
| Total Medicare Allowed Amount | 365314.45 |
| Total Medicare Payment Amount | 273456.34 |
| Total Medicare Standardized Payment Amount | 295447.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 500 |
| Number Of Medicare Beneficiaries With Drug Services | 349 |
| Total Drug Submitted ChargeAmount | 9989.5 |
| Total Drug Medicare AllowedAmount | 8051.37 |
| Total Drug Medicare PaymentAmount | 7759.61 |
| Total Drug Medicare Standardized Payment Amount | 7759.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 90 |
| Number Of Medical Services | 22531 |
| Number Of Medicare Beneficiaries With Medical Services | 650 |
| Total Medical Submitted Charge Amount | 542534.28 |
| Total Medical Medicare Allowed Amount | 357263.08 |
| Total Medical Medicare Payment Amount | 265696.73 |
| Total Medical Medicare Standardized Payment Amount | 287688.36 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 241 |
| Number Of Beneficiaries Age 75 to 84 | 223 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 385 |
| Number Of Male Beneficiaries | 265 |
| Number Of Non Hispanic White Beneficiaries | 518 |
| Number Of Black or African American Beneficiaries | |
| 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 | 525 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 125 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1699 |