National Provider Identifier [NPI]: |
1336189547 |
Last Name Of The Provider |
GREENE |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2828 E BARNETT RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEDFORD |
Zip Code Of The Provider |
975048342 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
112 |
Number Of Services |
27412 |
Number Of Medicare Beneficiaries |
482 |
Total Submitted Charge Amount |
906282 |
Total Medicare Allowed Amount |
327409.57 |
Total Medicare Payment Amount |
252544.81 |
Total Medicare Standardized Payment Amount |
273010.63 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
52 |
Number Of Drug Services |
24280 |
Number Of Medicare Beneficiaries With Drug Services |
99 |
Total Drug Submitted ChargeAmount |
430093 |
Total Drug Medicare AllowedAmount |
186437.05 |
Total Drug Medicare PaymentAmount |
145010.64 |
Total Drug Medicare Standardized Payment Amount |
145010.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
60 |
Number Of Medical Services |
3132 |
Number Of Medicare Beneficiaries With Medical Services |
482 |
Total Medical Submitted Charge Amount |
476189 |
Total Medical Medicare Allowed Amount |
140972.52 |
Total Medical Medicare Payment Amount |
107534.17 |
Total Medical Medicare Standardized Payment Amount |
127999.99 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
238 |
Number Of Beneficiaries Age 75 to 84 |
147 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
241 |
Number Of Male Beneficiaries |
241 |
Number Of Non Hispanic White Beneficiaries |
455 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
408 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
44 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
35 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
2.1988 |