| National Provider Identifier [NPI]: | 1467424903 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | JENA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2345 RICE ST STE 160 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551133769 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 2514 |
| Number Of Medicare Beneficiaries | 1441 |
| Total Submitted Charge Amount | 298598 |
| Total Medicare Allowed Amount | 91466.35 |
| Total Medicare Payment Amount | 70710.41 |
| Total Medicare Standardized Payment Amount | 54717.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 2514 |
| Number Of Medicare Beneficiaries With Medical Services | 1441 |
| Total Medical Submitted Charge Amount | 298598 |
| Total Medical Medicare Allowed Amount | 91466.35 |
| Total Medical Medicare Payment Amount | 70710.41 |
| Total Medical Medicare Standardized Payment Amount | 54717.56 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 149 |
| Number Of Beneficiaries Age 65 to 74 | 475 |
| Number Of Beneficiaries Age 75 to 84 | 493 |
| Number Of Beneficiaries Age Greater 84 | 324 |
| Number Of Female Beneficiaries | 787 |
| Number Of Male Beneficiaries | 654 |
| Number Of Non Hispanic White Beneficiaries | 1377 |
| Number Of Black or African American Beneficiaries | 23 |
| 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 | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1287 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 154 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0733 |