| National Provider Identifier [NPI]: | 1104809011 |
| Last Name Of The Provider | MARTINEZ |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1800 RYAN ST |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | LAKE CHARLES |
| Zip Code Of The Provider | 706016078 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 270 |
| Number Of Services | 8716.5 |
| Number Of Medicare Beneficiaries | 3959 |
| Total Submitted Charge Amount | 1179696.38 |
| Total Medicare Allowed Amount | 300754.47 |
| Total Medicare Payment Amount | 235321.77 |
| Total Medicare Standardized Payment Amount | 245665.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 167.5 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 1464.38 |
| Total Drug Medicare AllowedAmount | 320 |
| Total Drug Medicare PaymentAmount | 250.88 |
| Total Drug Medicare Standardized Payment Amount | 250.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 268 |
| Number Of Medical Services | 8549 |
| Number Of Medicare Beneficiaries With Medical Services | 3959 |
| Total Medical Submitted Charge Amount | 1178232 |
| Total Medical Medicare Allowed Amount | 300434.47 |
| Total Medical Medicare Payment Amount | 235070.89 |
| Total Medical Medicare Standardized Payment Amount | 245414.6 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 786 |
| Number Of Beneficiaries Age 65 to 74 | 1616 |
| Number Of Beneficiaries Age 75 to 84 | 1140 |
| Number Of Beneficiaries Age Greater 84 | 417 |
| Number Of Female Beneficiaries | 2897 |
| Number Of Male Beneficiaries | 1062 |
| Number Of Non Hispanic White Beneficiaries | 2887 |
| Number Of Black or African American Beneficiaries | 997 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2826 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1133 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5152 |