| National Provider Identifier [NPI]: | 1689882961 |
| Last Name Of The Provider | MANSON |
| First Name Of The Provider | GREG |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7337 CARITAS CIR NW |
| Street Address 2 Of The Provider | SUITE 15 |
| City Of The Provider | MASSILLON |
| Zip Code Of The Provider | 446469118 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 102 |
| Number Of Services | 25863 |
| Number Of Medicare Beneficiaries | 353 |
| Total Submitted Charge Amount | 964030 |
| Total Medicare Allowed Amount | 456197.88 |
| Total Medicare Payment Amount | 338087.39 |
| Total Medicare Standardized Payment Amount | 340400 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 50 |
| Number Of Drug Services | 23138 |
| Number Of Medicare Beneficiaries With Drug Services | 116 |
| Total Drug Submitted ChargeAmount | 766836 |
| Total Drug Medicare AllowedAmount | 369733.81 |
| Total Drug Medicare PaymentAmount | 272504.12 |
| Total Drug Medicare Standardized Payment Amount | 272504.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 2725 |
| Number Of Medicare Beneficiaries With Medical Services | 353 |
| Total Medical Submitted Charge Amount | 197194 |
| Total Medical Medicare Allowed Amount | 86464.07 |
| Total Medical Medicare Payment Amount | 65583.27 |
| Total Medical Medicare Standardized Payment Amount | 67895.88 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 143 |
| Number Of Beneficiaries Age 75 to 84 | 102 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 201 |
| Number Of Male Beneficiaries | 152 |
| Number Of Non Hispanic White Beneficiaries | 329 |
| 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 | 268 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 33 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.245 |