| National Provider Identifier [NPI]: | 1609893221 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1220 E ELM ST |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | LIMA |
| Zip Code Of The Provider | 458042850 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 114 |
| Number Of Services | 7889 |
| Number Of Medicare Beneficiaries | 355 |
| Total Submitted Charge Amount | 2528510 |
| Total Medicare Allowed Amount | 1193132.92 |
| Total Medicare Payment Amount | 929565.93 |
| Total Medicare Standardized Payment Amount | 933546.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 6293 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 2107116 |
| Total Drug Medicare AllowedAmount | 1071147.99 |
| Total Drug Medicare PaymentAmount | 837583.83 |
| Total Drug Medicare Standardized Payment Amount | 837583.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 107 |
| Number Of Medical Services | 1596 |
| Number Of Medicare Beneficiaries With Medical Services | 355 |
| Total Medical Submitted Charge Amount | 421394 |
| Total Medical Medicare Allowed Amount | 121984.93 |
| Total Medical Medicare Payment Amount | 91982.1 |
| Total Medical Medicare Standardized Payment Amount | 95962.58 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 178 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 100 |
| Number Of Male Beneficiaries | 255 |
| Number Of Non Hispanic White Beneficiaries | 294 |
| Number Of Black or African American Beneficiaries | 49 |
| 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 | 296 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 30 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5633 |