| National Provider Identifier [NPI]: | 1699786996 |
| Last Name Of The Provider | MORTENS |
| First Name Of The Provider | MARTIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6200 AURORA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | URBANDALE |
| Zip Code Of The Provider | 503222800 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 3806 |
| Number Of Medicare Beneficiaries | 341 |
| Total Submitted Charge Amount | 215974 |
| Total Medicare Allowed Amount | 97742.57 |
| Total Medicare Payment Amount | 70077.41 |
| Total Medicare Standardized Payment Amount | 76828.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 128 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 3226 |
| Total Drug Medicare AllowedAmount | 2496.91 |
| Total Drug Medicare PaymentAmount | 2410.57 |
| Total Drug Medicare Standardized Payment Amount | 2410.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 3678 |
| Number Of Medicare Beneficiaries With Medical Services | 341 |
| Total Medical Submitted Charge Amount | 212748 |
| Total Medical Medicare Allowed Amount | 95245.66 |
| Total Medical Medicare Payment Amount | 67666.84 |
| Total Medical Medicare Standardized Payment Amount | 74418.22 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 151 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 183 |
| Number Of Male Beneficiaries | 158 |
| Number Of Non Hispanic White Beneficiaries | 324 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 271 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8573 |