| National Provider Identifier [NPI]: | 1417985425 |
| Last Name Of The Provider | KEANE |
| First Name Of The Provider | MARTIN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3400 SPRUCE ST |
| Street Address 2 Of The Provider | 9 GATES |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191044206 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 1207 |
| Number Of Medicare Beneficiaries | 582 |
| Total Submitted Charge Amount | 194555 |
| Total Medicare Allowed Amount | 69586.6 |
| Total Medicare Payment Amount | 53244.27 |
| Total Medicare Standardized Payment Amount | 49398.28 |
| 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 | 25 |
| Number Of Medical Services | 1207 |
| Number Of Medicare Beneficiaries With Medical Services | 582 |
| Total Medical Submitted Charge Amount | 194555 |
| Total Medical Medicare Allowed Amount | 69586.6 |
| Total Medical Medicare Payment Amount | 53244.27 |
| Total Medical Medicare Standardized Payment Amount | 49398.28 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 184 |
| Number Of Beneficiaries Age 65 to 74 | 228 |
| Number Of Beneficiaries Age 75 to 84 | 123 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 287 |
| Number Of Male Beneficiaries | 295 |
| Number Of Non Hispanic White Beneficiaries | 232 |
| Number Of Black or African American Beneficiaries | 273 |
| 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 | 317 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 265 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 59 |
| Percent Of With Chronic Kidney Disease | 59 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.6634 |