| National Provider Identifier [NPI]: | 1861594970 |
| Last Name Of The Provider | KING |
| First Name Of The Provider | MARTA |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2600 WILSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILES CITY |
| Zip Code Of The Provider | 593015094 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 4327.9 |
| Number Of Medicare Beneficiaries | 702 |
| Total Submitted Charge Amount | 535965 |
| Total Medicare Allowed Amount | 426850.72 |
| Total Medicare Payment Amount | 311783.31 |
| Total Medicare Standardized Payment Amount | 311147.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1008.9 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 143360 |
| Total Drug Medicare AllowedAmount | 124391.43 |
| Total Drug Medicare PaymentAmount | 91568.78 |
| Total Drug Medicare Standardized Payment Amount | 91568.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 3319 |
| Number Of Medicare Beneficiaries With Medical Services | 702 |
| Total Medical Submitted Charge Amount | 392605 |
| Total Medical Medicare Allowed Amount | 302459.29 |
| Total Medical Medicare Payment Amount | 220214.53 |
| Total Medical Medicare Standardized Payment Amount | 219578.41 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 239 |
| Number Of Beneficiaries Age 75 to 84 | 249 |
| Number Of Beneficiaries Age Greater 84 | 183 |
| Number Of Female Beneficiaries | 394 |
| Number Of Male Beneficiaries | 308 |
| Number Of Non Hispanic White Beneficiaries | 682 |
| 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 | 606 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9958 |