National Provider Identifier [NPI]: |
1275761603 |
Last Name Of The Provider |
MARTENS |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3700 W 203RD ST |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
OLYMPIA FIELDS |
Zip Code Of The Provider |
604611180 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
471 |
Number Of Medicare Beneficiaries |
196 |
Total Submitted Charge Amount |
96434.17 |
Total Medicare Allowed Amount |
90349.43 |
Total Medicare Payment Amount |
69354.03 |
Total Medicare Standardized Payment Amount |
62563.67 |
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 |
79 |
Number Of Medical Services |
471 |
Number Of Medicare Beneficiaries With Medical Services |
196 |
Total Medical Submitted Charge Amount |
96434.17 |
Total Medical Medicare Allowed Amount |
90349.43 |
Total Medical Medicare Payment Amount |
69354.03 |
Total Medical Medicare Standardized Payment Amount |
62563.67 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
108 |
Number Of Male Beneficiaries |
88 |
Number Of Non Hispanic White Beneficiaries |
120 |
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 |
139 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
28 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.7012 |