| National Provider Identifier [NPI]: | 1366436818 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | RANDOLPH |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2901 OLD JACKSONVILLE RD |
| Street Address 2 Of The Provider | SUITE D |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627047437 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 15241 |
| Number Of Medicare Beneficiaries | 1525 |
| Total Submitted Charge Amount | 726922.49 |
| Total Medicare Allowed Amount | 577578.88 |
| Total Medicare Payment Amount | 428710.89 |
| Total Medicare Standardized Payment Amount | 455352.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 9396 |
| Number Of Medicare Beneficiaries With Drug Services | 130 |
| Total Drug Submitted ChargeAmount | 38021.21 |
| Total Drug Medicare AllowedAmount | 27088.7 |
| Total Drug Medicare PaymentAmount | 21210.32 |
| Total Drug Medicare Standardized Payment Amount | 21210.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 5845 |
| Number Of Medicare Beneficiaries With Medical Services | 1525 |
| Total Medical Submitted Charge Amount | 688901.28 |
| Total Medical Medicare Allowed Amount | 550490.18 |
| Total Medical Medicare Payment Amount | 407500.57 |
| Total Medical Medicare Standardized Payment Amount | 434142.43 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 197 |
| Number Of Beneficiaries Age 65 to 74 | 519 |
| Number Of Beneficiaries Age 75 to 84 | 486 |
| Number Of Beneficiaries Age Greater 84 | 323 |
| Number Of Female Beneficiaries | 789 |
| Number Of Male Beneficiaries | 736 |
| Number Of Non Hispanic White Beneficiaries | 1414 |
| Number Of Black or African American Beneficiaries | 82 |
| 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 | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1211 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 314 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.7946 |