| National Provider Identifier [NPI]: | 1578550935 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | MARYANN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1051 PORT MALABAR BLVD NE |
| Street Address 2 Of The Provider | SUITE 6, PORT MALABAR PROFESSIONAL BLDG |
| City Of The Provider | PALM BAY |
| Zip Code Of The Provider | 329055153 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 610 |
| Number Of Medicare Beneficiaries | 243 |
| Total Submitted Charge Amount | 100440 |
| Total Medicare Allowed Amount | 41005.2 |
| Total Medicare Payment Amount | 25591.8 |
| Total Medicare Standardized Payment Amount | 32142.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 101 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 810 |
| Total Drug Medicare AllowedAmount | 79.9 |
| Total Drug Medicare PaymentAmount | 53.74 |
| Total Drug Medicare Standardized Payment Amount | 53.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 509 |
| Number Of Medicare Beneficiaries With Medical Services | 243 |
| Total Medical Submitted Charge Amount | 99630 |
| Total Medical Medicare Allowed Amount | 40925.3 |
| Total Medical Medicare Payment Amount | 25538.06 |
| Total Medical Medicare Standardized Payment Amount | 32088.92 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 139 |
| Number Of Beneficiaries Age 65 to 74 | 61 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 153 |
| Number Of Male Beneficiaries | 90 |
| Number Of Non Hispanic White Beneficiaries | 199 |
| Number Of Black or African American Beneficiaries | 27 |
| 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 | 156 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 1.375 |