| National Provider Identifier [NPI]: | 1740249861 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 259 MAIN STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | YARMOUTH |
| Zip Code Of The Provider | 04096 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 3374 |
| Number Of Medicare Beneficiaries | 257 |
| Total Submitted Charge Amount | 215847.5 |
| Total Medicare Allowed Amount | 104246.48 |
| Total Medicare Payment Amount | 78776.08 |
| Total Medicare Standardized Payment Amount | 78978.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 253 |
| Number Of Medicare Beneficiaries With Drug Services | 122 |
| Total Drug Submitted ChargeAmount | 8152.5 |
| Total Drug Medicare AllowedAmount | 5614.02 |
| Total Drug Medicare PaymentAmount | 5458.35 |
| Total Drug Medicare Standardized Payment Amount | 5458.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 91 |
| Number Of Medical Services | 3121 |
| Number Of Medicare Beneficiaries With Medical Services | 257 |
| Total Medical Submitted Charge Amount | 207695 |
| Total Medical Medicare Allowed Amount | 98632.46 |
| Total Medical Medicare Payment Amount | 73317.73 |
| Total Medical Medicare Standardized Payment Amount | 73520.64 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 98 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 138 |
| Number Of Male Beneficiaries | 119 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 232 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8538 |