National Provider Identifier [NPI]: |
1104821735 |
Last Name Of The Provider |
GREENWELL |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3950 KRESGE WAY |
Street Address 2 Of The Provider |
STE 207 |
City Of The Provider |
LOUISVILLE |
Zip Code Of The Provider |
402074637 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
1530 |
Number Of Medicare Beneficiaries |
785 |
Total Submitted Charge Amount |
471015.03 |
Total Medicare Allowed Amount |
161711.34 |
Total Medicare Payment Amount |
119263.73 |
Total Medicare Standardized Payment Amount |
131275.02 |
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 |
36 |
Number Of Medical Services |
1530 |
Number Of Medicare Beneficiaries With Medical Services |
785 |
Total Medical Submitted Charge Amount |
471015.03 |
Total Medical Medicare Allowed Amount |
161711.34 |
Total Medical Medicare Payment Amount |
119263.73 |
Total Medical Medicare Standardized Payment Amount |
131275.02 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
304 |
Number Of Beneficiaries Age 75 to 84 |
264 |
Number Of Beneficiaries Age Greater 84 |
129 |
Number Of Female Beneficiaries |
478 |
Number Of Male Beneficiaries |
307 |
Number Of Non Hispanic White Beneficiaries |
722 |
Number Of Black or African American Beneficiaries |
47 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
687 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
98 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.6518 |