| National Provider Identifier [NPI]: | 1760441927 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1515 DELHI ST |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | DUBUQUE |
| Zip Code Of The Provider | 520016320 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 105 |
| Number Of Services | 4383 |
| Number Of Medicare Beneficiaries | 1193 |
| Total Submitted Charge Amount | 1051826 |
| Total Medicare Allowed Amount | 279508.97 |
| Total Medicare Payment Amount | 209843.19 |
| Total Medicare Standardized Payment Amount | 228138.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 687 |
| Total Drug Medicare AllowedAmount | 439.08 |
| Total Drug Medicare PaymentAmount | 430.27 |
| Total Drug Medicare Standardized Payment Amount | 430.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 4354 |
| Number Of Medicare Beneficiaries With Medical Services | 1193 |
| Total Medical Submitted Charge Amount | 1051139 |
| Total Medical Medicare Allowed Amount | 279069.89 |
| Total Medical Medicare Payment Amount | 209412.92 |
| Total Medical Medicare Standardized Payment Amount | 227708.19 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 121 |
| Number Of Beneficiaries Age 65 to 74 | 447 |
| Number Of Beneficiaries Age 75 to 84 | 421 |
| Number Of Beneficiaries Age Greater 84 | 204 |
| Number Of Female Beneficiaries | 543 |
| Number Of Male Beneficiaries | 650 |
| Number Of Non Hispanic White Beneficiaries | 1167 |
| 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 | 1006 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 187 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6587 |