| National Provider Identifier [NPI]: | 1922046200 |
| Last Name Of The Provider | GREEN |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5959 PARK AVE |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 381195200 |
| 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 | 227 |
| Number Of Services | 14832 |
| Number Of Medicare Beneficiaries | 3544 |
| Total Submitted Charge Amount | 1533477 |
| Total Medicare Allowed Amount | 355390.03 |
| Total Medicare Payment Amount | 272241.51 |
| Total Medicare Standardized Payment Amount | 291391.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 9068 |
| Number Of Medicare Beneficiaries With Drug Services | 113 |
| Total Drug Submitted ChargeAmount | 18179 |
| Total Drug Medicare AllowedAmount | 3301.67 |
| Total Drug Medicare PaymentAmount | 2539.27 |
| Total Drug Medicare Standardized Payment Amount | 2539.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 220 |
| Number Of Medical Services | 5764 |
| Number Of Medicare Beneficiaries With Medical Services | 3543 |
| Total Medical Submitted Charge Amount | 1515298 |
| Total Medical Medicare Allowed Amount | 352088.36 |
| Total Medical Medicare Payment Amount | 269702.24 |
| Total Medical Medicare Standardized Payment Amount | 288851.91 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 782 |
| Number Of Beneficiaries Age 65 to 74 | 1351 |
| Number Of Beneficiaries Age 75 to 84 | 952 |
| Number Of Beneficiaries Age Greater 84 | 459 |
| Number Of Female Beneficiaries | 2352 |
| Number Of Male Beneficiaries | 1192 |
| Number Of Non Hispanic White Beneficiaries | 2273 |
| Number Of Black or African American Beneficiaries | 1191 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2412 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1132 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8396 |