| National Provider Identifier [NPI]: | 1972557858 |
| Last Name Of The Provider | GREEN |
| First Name Of The Provider | LANNY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 23077 GREENFIELD RD |
| Street Address 2 Of The Provider | 144 |
| City Of The Provider | SOUTHFIELD |
| Zip Code Of The Provider | 480753709 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 6091 |
| Number Of Medicare Beneficiaries | 915 |
| Total Submitted Charge Amount | 1555290 |
| Total Medicare Allowed Amount | 645371.81 |
| Total Medicare Payment Amount | 482465.35 |
| Total Medicare Standardized Payment Amount | 473442.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 6091 |
| Number Of Medicare Beneficiaries With Medical Services | 915 |
| Total Medical Submitted Charge Amount | 1555290 |
| Total Medical Medicare Allowed Amount | 645371.81 |
| Total Medical Medicare Payment Amount | 482465.35 |
| Total Medical Medicare Standardized Payment Amount | 473442.14 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 312 |
| Number Of Beneficiaries Age 65 to 74 | 325 |
| Number Of Beneficiaries Age 75 to 84 | 206 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 589 |
| Number Of Male Beneficiaries | 326 |
| Number Of Non Hispanic White Beneficiaries | 74 |
| Number Of Black or African American Beneficiaries | 827 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 455 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 460 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6663 |