| National Provider Identifier [NPI]: | 1902874704 |
| Last Name Of The Provider | GREEN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7829 YOUREE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHREVEPORT |
| Zip Code Of The Provider | 711055505 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 4273 |
| Number Of Medicare Beneficiaries | 1044 |
| Total Submitted Charge Amount | 644226.26 |
| Total Medicare Allowed Amount | 423660.27 |
| Total Medicare Payment Amount | 320846.84 |
| Total Medicare Standardized Payment Amount | 339334.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 80 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 2127.26 |
| Total Drug Medicare AllowedAmount | 164.75 |
| Total Drug Medicare PaymentAmount | 156.86 |
| Total Drug Medicare Standardized Payment Amount | 156.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 4193 |
| Number Of Medicare Beneficiaries With Medical Services | 1044 |
| Total Medical Submitted Charge Amount | 642099 |
| Total Medical Medicare Allowed Amount | 423495.52 |
| Total Medical Medicare Payment Amount | 320689.98 |
| Total Medical Medicare Standardized Payment Amount | 339177.47 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 118 |
| Number Of Beneficiaries Age 65 to 74 | 389 |
| Number Of Beneficiaries Age 75 to 84 | 386 |
| Number Of Beneficiaries Age Greater 84 | 151 |
| Number Of Female Beneficiaries | 601 |
| Number Of Male Beneficiaries | 443 |
| Number Of Non Hispanic White Beneficiaries | 829 |
| Number Of Black or African American Beneficiaries | 204 |
| 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 | 816 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 228 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 62 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.2272 |