| National Provider Identifier [NPI]: | 1710088380 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | CASEY |
| 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 | 580 RICE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551032148 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 519 |
| Number Of Medicare Beneficiaries | 110 |
| Total Submitted Charge Amount | 75127 |
| Total Medicare Allowed Amount | 30985.98 |
| Total Medicare Payment Amount | 23522.34 |
| Total Medicare Standardized Payment Amount | 24239.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1178 |
| Total Drug Medicare AllowedAmount | 634.41 |
| Total Drug Medicare PaymentAmount | 611.34 |
| Total Drug Medicare Standardized Payment Amount | 611.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 487 |
| Number Of Medicare Beneficiaries With Medical Services | 110 |
| Total Medical Submitted Charge Amount | 73949 |
| Total Medical Medicare Allowed Amount | 30351.57 |
| Total Medical Medicare Payment Amount | 22911 |
| Total Medical Medicare Standardized Payment Amount | 23627.83 |
| Average Age Of Beneficiaries | 57 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 14 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 55 |
| Number Of Male Beneficiaries | 55 |
| Number Of Non Hispanic White Beneficiaries | 53 |
| Number Of Black or African American Beneficiaries | 41 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 24 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.9422 |