| National Provider Identifier [NPI]: | 1497710008 |
| Last Name Of The Provider | MARTIN |
| First Name Of The Provider | LARRY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4003 KRESGE WAY |
| Street Address 2 Of The Provider | STE 228 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 40207 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 2310 |
| Number Of Medicare Beneficiaries | 509 |
| Total Submitted Charge Amount | 243031 |
| Total Medicare Allowed Amount | 144575.06 |
| Total Medicare Payment Amount | 96059.29 |
| Total Medicare Standardized Payment Amount | 104731.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 224 |
| Number Of Medicare Beneficiaries With Drug Services | 164 |
| Total Drug Submitted ChargeAmount | 7650 |
| Total Drug Medicare AllowedAmount | 5307.32 |
| Total Drug Medicare PaymentAmount | 5163.82 |
| Total Drug Medicare Standardized Payment Amount | 5163.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 2086 |
| Number Of Medicare Beneficiaries With Medical Services | 509 |
| Total Medical Submitted Charge Amount | 235381 |
| Total Medical Medicare Allowed Amount | 139267.74 |
| Total Medical Medicare Payment Amount | 90895.47 |
| Total Medical Medicare Standardized Payment Amount | 99567.6 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 193 |
| Number Of Beneficiaries Age Greater 84 | 109 |
| Number Of Female Beneficiaries | 262 |
| Number Of Male Beneficiaries | 247 |
| Number Of Non Hispanic White Beneficiaries | 484 |
| 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 | 496 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9945 |