| National Provider Identifier [NPI]: | 1508843798 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | AMY |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9 CRANBROOK BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ENFIELD |
| Zip Code Of The Provider | 060823889 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 9340 |
| Number Of Medicare Beneficiaries | 3017 |
| Total Submitted Charge Amount | 561417.35 |
| Total Medicare Allowed Amount | 212768.25 |
| Total Medicare Payment Amount | 163461.89 |
| Total Medicare Standardized Payment Amount | 150847.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 5023 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 2260.35 |
| Total Drug Medicare AllowedAmount | 911.53 |
| Total Drug Medicare PaymentAmount | 714.61 |
| Total Drug Medicare Standardized Payment Amount | 714.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 4317 |
| Number Of Medicare Beneficiaries With Medical Services | 3017 |
| Total Medical Submitted Charge Amount | 559157 |
| Total Medical Medicare Allowed Amount | 211856.72 |
| Total Medical Medicare Payment Amount | 162747.28 |
| Total Medical Medicare Standardized Payment Amount | 150132.45 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 452 |
| Number Of Beneficiaries Age 65 to 74 | 1142 |
| Number Of Beneficiaries Age 75 to 84 | 939 |
| Number Of Beneficiaries Age Greater 84 | 484 |
| Number Of Female Beneficiaries | 2047 |
| Number Of Male Beneficiaries | 970 |
| Number Of Non Hispanic White Beneficiaries | 2331 |
| Number Of Black or African American Beneficiaries | 380 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 207 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 58 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2063 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 954 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.466 |