| National Provider Identifier [NPI]: | 1386716686 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | TIMOTHY |
| 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 | 950 N 19TH |
| Street Address 2 Of The Provider | #100 |
| City Of The Provider | ABILENE |
| Zip Code Of The Provider | 796012420 |
| 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 | 27 |
| Number Of Services | 1129.5 |
| Number Of Medicare Beneficiaries | 245 |
| Total Submitted Charge Amount | 73903.86 |
| Total Medicare Allowed Amount | 63106.16 |
| Total Medicare Payment Amount | 43417.64 |
| Total Medicare Standardized Payment Amount | 49719.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 77.5 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 306.42 |
| Total Drug Medicare AllowedAmount | 239.57 |
| Total Drug Medicare PaymentAmount | 163.95 |
| Total Drug Medicare Standardized Payment Amount | 163.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 1052 |
| Number Of Medicare Beneficiaries With Medical Services | 245 |
| Total Medical Submitted Charge Amount | 73597.44 |
| Total Medical Medicare Allowed Amount | 62866.59 |
| Total Medical Medicare Payment Amount | 43253.69 |
| Total Medical Medicare Standardized Payment Amount | 49555.95 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 83 |
| Number Of Beneficiaries Age 75 to 84 | 67 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 135 |
| Number Of Male Beneficiaries | 110 |
| Number Of Non Hispanic White Beneficiaries | 218 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 170 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 23 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0286 |