| National Provider Identifier [NPI]: | 1689615973 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 350 E SARNIA ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WINONA |
| Zip Code Of The Provider | 559873803 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 2572.4 |
| Number Of Medicare Beneficiaries | 82 |
| Total Submitted Charge Amount | 181887.82 |
| Total Medicare Allowed Amount | 79128.03 |
| Total Medicare Payment Amount | 56668.84 |
| Total Medicare Standardized Payment Amount | 59312.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1522.4 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 22159.82 |
| Total Drug Medicare AllowedAmount | 11407.85 |
| Total Drug Medicare PaymentAmount | 8929.54 |
| Total Drug Medicare Standardized Payment Amount | 8929.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 1050 |
| Number Of Medicare Beneficiaries With Medical Services | 82 |
| Total Medical Submitted Charge Amount | 159728 |
| Total Medical Medicare Allowed Amount | 67720.18 |
| Total Medical Medicare Payment Amount | 47739.3 |
| Total Medical Medicare Standardized Payment Amount | 50382.47 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 22 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 57 |
| Number Of Male Beneficiaries | 25 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 48 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 27 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9652 |