| National Provider Identifier [NPI]: | 1720399280 |
| Last Name Of The Provider | LAFOLLETTE |
| First Name Of The Provider | MARTIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10180 W HAPPY VALLEY RD STE 100 |
| Street Address 2 Of The Provider | |
| City Of The Provider | PEORIA |
| Zip Code Of The Provider | 853831389 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 454 |
| Number Of Medicare Beneficiaries | 126 |
| Total Submitted Charge Amount | 87374 |
| Total Medicare Allowed Amount | 35147.45 |
| Total Medicare Payment Amount | 25005.21 |
| Total Medicare Standardized Payment Amount | 25214.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 41 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 3153 |
| Total Drug Medicare AllowedAmount | 1417.83 |
| Total Drug Medicare PaymentAmount | 1388.69 |
| Total Drug Medicare Standardized Payment Amount | 1388.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 413 |
| Number Of Medicare Beneficiaries With Medical Services | 126 |
| Total Medical Submitted Charge Amount | 84221 |
| Total Medical Medicare Allowed Amount | 33729.62 |
| Total Medical Medicare Payment Amount | 23616.52 |
| Total Medical Medicare Standardized Payment Amount | 23825.37 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 84 |
| Number Of Beneficiaries Age 75 to 84 | 21 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 68 |
| Number Of Male Beneficiaries | 58 |
| 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 | 115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 10 |
| 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 | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 25 |
| 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 | 0.7945 |