| National Provider Identifier [NPI]: | 1144226572 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 333 N. SANTA ROSA |
| Street Address 2 Of The Provider | CENTER FOR CHILDREN & FAMILIES, 4TH FLOOR, CLINIC A |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 78207 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 556 |
| Number Of Medicare Beneficiaries | 101 |
| Total Submitted Charge Amount | 49894.52 |
| Total Medicare Allowed Amount | 32897.6 |
| Total Medicare Payment Amount | 23942.65 |
| Total Medicare Standardized Payment Amount | 25604.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 89 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 1034.07 |
| Total Drug Medicare AllowedAmount | 759.24 |
| Total Drug Medicare PaymentAmount | 692.5 |
| Total Drug Medicare Standardized Payment Amount | 692.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 467 |
| Number Of Medicare Beneficiaries With Medical Services | 101 |
| Total Medical Submitted Charge Amount | 48860.45 |
| Total Medical Medicare Allowed Amount | 32138.36 |
| Total Medical Medicare Payment Amount | 23250.15 |
| Total Medical Medicare Standardized Payment Amount | 24911.62 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 59 |
| Number Of Male Beneficiaries | 42 |
| Number Of Non Hispanic White Beneficiaries | 80 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7318 |