| National Provider Identifier [NPI]: | 1669416186 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1524 MCHENRY AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MODESTO |
| Zip Code Of The Provider | 953504500 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 151 |
| Number Of Services | 7616 |
| Number Of Medicare Beneficiaries | 3171 |
| Total Submitted Charge Amount | 884122.95 |
| Total Medicare Allowed Amount | 182844.59 |
| Total Medicare Payment Amount | 135076.71 |
| Total Medicare Standardized Payment Amount | 131946.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2367 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 2688 |
| Total Drug Medicare AllowedAmount | 459.37 |
| Total Drug Medicare PaymentAmount | 341.18 |
| Total Drug Medicare Standardized Payment Amount | 341.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 149 |
| Number Of Medical Services | 5249 |
| Number Of Medicare Beneficiaries With Medical Services | 3171 |
| Total Medical Submitted Charge Amount | 881434.95 |
| Total Medical Medicare Allowed Amount | 182385.22 |
| Total Medical Medicare Payment Amount | 134735.53 |
| Total Medical Medicare Standardized Payment Amount | 131605.08 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 580 |
| Number Of Beneficiaries Age 65 to 74 | 1255 |
| Number Of Beneficiaries Age 75 to 84 | 869 |
| Number Of Beneficiaries Age Greater 84 | 467 |
| Number Of Female Beneficiaries | 1982 |
| Number Of Male Beneficiaries | 1189 |
| Number Of Non Hispanic White Beneficiaries | 2217 |
| Number Of Black or African American Beneficiaries | 51 |
| Number Of AsianPacific Islander Beneficiaries | 143 |
| Number Of Hispanic Beneficiaries | 700 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1721 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1450 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.608 |