Holly Martinez NP-C

Gender: F
Medical School: Other
Graduation Year: 2008
Primary Specialty: Nurse Practitioner

2017 Medicare Provider Charge and Payment Data

Medicare Participation?Y
Number of unique HCPCS codes submitted15
Total Provider Services900
Total Medicare beneficiaries receiving the provider services243
The total charges that the provider submitted for all services$125,399.85
The Medicare allowed amount for all provider services. This figure is the sum of the amount Medicare pays, the deductible and coinsurance amounts that the beneficiary is responsible for paying, and any amounts that a third party is responsible for paying.$32,680.27
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item services.$24,274.03
Total Medicare Standardized Payment Amount$25,272.56
Total number of HCPCS codes for drug services, as defined from the Medicare Part B Drug ASP File4
Total drug services, as defined from the Medicare Part B Drug ASP File503
Total Medicare beneficiaries receiving drug services, as defined from the Medicare Part B Drug ASP File.16
The total charges that the provider submitted for drug services, as defined from the Medicare Part B Drug ASP File.$2,817.85
The Medicare allowed amount for drug services, as defined from the Medicare Part B Drug ASP File. This figure is the sum of the amount Medicare pays, the deductible and coinsurance amounts that the beneficiary is responsible for paying, and any amounts that a third party is responsible for paying.$1,173.07
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item drug services, as defined from the Medicare Part B Drug ASP File.$1,054.23
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for the line item drug service , as defined from the Medicare Part B Drug ASP File and after standardization of the Medicare payment has been applied. Standardization removes geographic differences in payment rates for individual services, such as those that account for local wages or input prices and makes Medicare payments across geographic areas comparable, so that differences reflect variation in factors such as physicians’ practice patterns and beneficiaries’ ability and willingness to obtain care.$1,054.23
Total number of HCPCS codes associated with medical (non-ASP) services11
Total medical (non-ASP) services397
Total Medicare beneficiaries receiving medical (non-ASP) services243
The total charges that the provider submitted for medical services (non-ASP)$122,582.00
The Medicare allowed amount for medical (non-ASP) services. This figure is the sum of the amount Medicare pays, the deductible and coinsurance amounts that the beneficiary is responsible for paying, and any amounts that a third party is responsible for paying.$31,507.20
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for all the provider's line item medical (non-ASP) services$23,219.80
Total amount that Medicare paid after deductible and coinsurance amounts have been deducted for the line item medical (non-ASP) service , as defined from the Medicare Part B Drug ASP File and after standardization of the Medicare payment has been applied. Standardization removes geographic differences in payment rates for individual services, such as those that account for local wages or input prices and makes Medicare payments across geographic areas comparable, so that differences reflect variation in factors such as physicians’ practice patterns and beneficiaries’ ability and willingness to obtain care$24,218.33
Average age of beneficiaries74
Number of beneficiaries under the age of 6520
Number of beneficiaries between the ages of 65 and 74100
Number of beneficiaries between the ages of 75 and 8497
Number of beneficiaries over the age of 8426
Number of Female beneficiaries142
Number of Male Beneficiaries101
Number of Non-Hispanic White Beneficiaries227
Number of Asian Pacific Islander Beneficiaries0
Number of American Indian/Alaska Native Beneficiaries0
Number of Medicare beneficiaries qualified to receive Medicare only benefits. Beneficiaries are classified as Medicare only entitlement if they received zero months of any Medicaid benefits (full or partial) in the given calendar year217
Number of Medicare beneficiaries qualified to receive Medicare and Medicaid benefits. Beneficiaries are classified as Medicare and Medicaid entitlement if in any month in the given calendar year they were receiving full or partial Medicaid benefits26
Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation12%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia6%
Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma6%
Percent of beneficiaries meeting the CCW chronic condition algorithms for cancer. Includes breast cancer, colorectal cancer, lung cancer and prostate cancer60%
Percent of beneficiaries meeting the CCW chronic condition algorithm for heart failure17%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease35%
Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease22%
Percent of beneficiaries meeting the CCW chronic condition algorithm for depression17%
Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes32%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia52%
Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension69%
Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease30%
Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis9%
Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis46%
Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke6%
Average Hierarchical Condition Category (HCC) risk score of beneficiaries1.9556

Source: data.cms.gov

Holly Martinez NP-C's 2017 Charges to Medicare:

Services Description Times Provided Beneficiaries Beneficiaries per day Medicare Avg. Amt. Average Charge Avg Medicare Payment Percentage of Average
Vaccine for influenza for injection into muscle 14 14 14 $49.03 $75.0 $48.05 156%
Established patient office or other outpatient visit, typically 15 minutes 54 46 54 $60.29 $219.0 $34.51 635%
Established patient office or other outpatient, visit typically 25 minutes 29 24 29 $66.16 $339.0 $50.98 665%
Established patient office or other outpatient, visit typically 25 minutes 281 176 281 $88.85 $339.0 $66.69 508%
Administration of influenza virus vaccine 14 14 14 $24.25 $33.0 $23.76 139%
Source: 2017 Provider CMS Charge Data