| National Provider Identifier [NPI]: | 1134123763 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12554 RIATA VISTA CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787276431 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 221 |
| Number Of Services | 6468 |
| Number Of Medicare Beneficiaries | 2799 |
| Total Submitted Charge Amount | 701312.5 |
| Total Medicare Allowed Amount | 162238.73 |
| Total Medicare Payment Amount | 123464.07 |
| Total Medicare Standardized Payment Amount | 126721.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2004 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 1807 |
| Total Drug Medicare AllowedAmount | 495.87 |
| Total Drug Medicare PaymentAmount | 370.15 |
| Total Drug Medicare Standardized Payment Amount | 370.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 218 |
| Number Of Medical Services | 4464 |
| Number Of Medicare Beneficiaries With Medical Services | 2799 |
| Total Medical Submitted Charge Amount | 699505.5 |
| Total Medical Medicare Allowed Amount | 161742.86 |
| Total Medical Medicare Payment Amount | 123093.92 |
| Total Medical Medicare Standardized Payment Amount | 126351.53 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 529 |
| Number Of Beneficiaries Age 65 to 74 | 1013 |
| Number Of Beneficiaries Age 75 to 84 | 800 |
| Number Of Beneficiaries Age Greater 84 | 457 |
| Number Of Female Beneficiaries | 1483 |
| Number Of Male Beneficiaries | 1316 |
| Number Of Non Hispanic White Beneficiaries | 2001 |
| Number Of Black or African American Beneficiaries | 246 |
| Number Of AsianPacific Islander Beneficiaries | 49 |
| Number Of Hispanic Beneficiaries | 479 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2036 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 763 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0627 |