| National Provider Identifier [NPI]: | 1902805419 |
| Last Name Of The Provider | GREENE |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 416 CONNABLE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PETOSKEY |
| Zip Code Of The Provider | 497702212 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 203 |
| Number Of Services | 5873 |
| Number Of Medicare Beneficiaries | 3672 |
| Total Submitted Charge Amount | 623053.91 |
| Total Medicare Allowed Amount | 222833.42 |
| Total Medicare Payment Amount | 172430.12 |
| Total Medicare Standardized Payment Amount | 179052.87 |
| 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 | 203 |
| Number Of Medical Services | 5873 |
| Number Of Medicare Beneficiaries With Medical Services | 3672 |
| Total Medical Submitted Charge Amount | 623053.91 |
| Total Medical Medicare Allowed Amount | 222833.42 |
| Total Medical Medicare Payment Amount | 172430.12 |
| Total Medical Medicare Standardized Payment Amount | 179052.87 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 708 |
| Number Of Beneficiaries Age 65 to 74 | 1458 |
| Number Of Beneficiaries Age 75 to 84 | 1021 |
| Number Of Beneficiaries Age Greater 84 | 485 |
| Number Of Female Beneficiaries | 2052 |
| Number Of Male Beneficiaries | 1620 |
| Number Of Non Hispanic White Beneficiaries | 3480 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 145 |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2854 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 818 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3361 |