| National Provider Identifier [NPI]: | 1033143714 |
| Last Name Of The Provider | GREEN |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1661 INTERNATIONAL PLACE DRIVE |
| Street Address 2 Of The Provider | SUITE 350 |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 38120 |
| 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 | 123 |
| Number Of Services | 3440 |
| Number Of Medicare Beneficiaries | 2640 |
| Total Submitted Charge Amount | 380040 |
| Total Medicare Allowed Amount | 80693.8 |
| Total Medicare Payment Amount | 61677.35 |
| Total Medicare Standardized Payment Amount | 65566.18 |
| 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 | 123 |
| Number Of Medical Services | 3440 |
| Number Of Medicare Beneficiaries With Medical Services | 2640 |
| Total Medical Submitted Charge Amount | 380040 |
| Total Medical Medicare Allowed Amount | 80693.8 |
| Total Medical Medicare Payment Amount | 61677.35 |
| Total Medical Medicare Standardized Payment Amount | 65566.18 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 741 |
| Number Of Beneficiaries Age 65 to 74 | 886 |
| Number Of Beneficiaries Age 75 to 84 | 632 |
| Number Of Beneficiaries Age Greater 84 | 381 |
| Number Of Female Beneficiaries | 1591 |
| Number Of Male Beneficiaries | 1049 |
| Number Of Non Hispanic White Beneficiaries | 1342 |
| Number Of Black or African American Beneficiaries | 1264 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1655 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 985 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.3547 |