National Provider Identifier [NPI]: |
1184646929 |
Last Name Of The Provider |
GREEN |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
210 25TH AVE N |
Street Address 2 Of The Provider |
SUITE 602 |
City Of The Provider |
NASHVILLE |
Zip Code Of The Provider |
372031606 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
193 |
Number Of Services |
18449 |
Number Of Medicare Beneficiaries |
2567 |
Total Submitted Charge Amount |
1285272.82 |
Total Medicare Allowed Amount |
235906.22 |
Total Medicare Payment Amount |
181574.99 |
Total Medicare Standardized Payment Amount |
200696.35 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
13031 |
Number Of Medicare Beneficiaries With Drug Services |
130 |
Total Drug Submitted ChargeAmount |
2491.25 |
Total Drug Medicare AllowedAmount |
2491.25 |
Total Drug Medicare PaymentAmount |
1936.71 |
Total Drug Medicare Standardized Payment Amount |
1936.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
188 |
Number Of Medical Services |
5418 |
Number Of Medicare Beneficiaries With Medical Services |
2567 |
Total Medical Submitted Charge Amount |
1282781.57 |
Total Medical Medicare Allowed Amount |
233414.97 |
Total Medical Medicare Payment Amount |
179638.28 |
Total Medical Medicare Standardized Payment Amount |
198759.64 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
533 |
Number Of Beneficiaries Age 65 to 74 |
1008 |
Number Of Beneficiaries Age 75 to 84 |
649 |
Number Of Beneficiaries Age Greater 84 |
377 |
Number Of Female Beneficiaries |
1620 |
Number Of Male Beneficiaries |
947 |
Number Of Non Hispanic White Beneficiaries |
2311 |
Number Of Black or African American Beneficiaries |
189 |
Number Of AsianPacific Islander Beneficiaries |
32 |
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1924 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
643 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6726 |