| National Provider Identifier [NPI]: | 1073730867 |
| Last Name Of The Provider | DILLOW |
| First Name Of The Provider | MARTIN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 505 S PLUMMER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHANUTE |
| Zip Code Of The Provider | 667201950 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Multispecialty Clinic/Group Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 185 |
| Number Of Services | 11886 |
| Number Of Medicare Beneficiaries | 466 |
| Total Submitted Charge Amount | 704842 |
| Total Medicare Allowed Amount | 300379.38 |
| Total Medicare Payment Amount | 233273.63 |
| Total Medicare Standardized Payment Amount | 236964.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 54 |
| Number Of Drug Services | 9222 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 434028 |
| Total Drug Medicare AllowedAmount | 201407.51 |
| Total Drug Medicare PaymentAmount | 157863.36 |
| Total Drug Medicare Standardized Payment Amount | 157863.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 131 |
| Number Of Medical Services | 2664 |
| Number Of Medicare Beneficiaries With Medical Services | 466 |
| Total Medical Submitted Charge Amount | 270814 |
| Total Medical Medicare Allowed Amount | 98971.87 |
| Total Medical Medicare Payment Amount | 75410.27 |
| Total Medical Medicare Standardized Payment Amount | 79100.96 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 178 |
| Number Of Beneficiaries Age 75 to 84 | 146 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 258 |
| Number Of Male Beneficiaries | 208 |
| Number Of Non Hispanic White Beneficiaries | 438 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 349 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 117 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2608 |