National Provider Identifier [NPI]: |
1629003538 |
Last Name Of The Provider |
GREEN |
First Name Of The Provider |
PRESTON |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
350 NW 76TH DR |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
GAINESVILLE |
Zip Code Of The Provider |
326071593 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
4382 |
Number Of Medicare Beneficiaries |
1063 |
Total Submitted Charge Amount |
1038041.98 |
Total Medicare Allowed Amount |
471058.31 |
Total Medicare Payment Amount |
356134.22 |
Total Medicare Standardized Payment Amount |
372386.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
672 |
Number Of Medicare Beneficiaries With Drug Services |
117 |
Total Drug Submitted ChargeAmount |
7131.98 |
Total Drug Medicare AllowedAmount |
3218.7 |
Total Drug Medicare PaymentAmount |
2509.24 |
Total Drug Medicare Standardized Payment Amount |
2509.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
3710 |
Number Of Medicare Beneficiaries With Medical Services |
1063 |
Total Medical Submitted Charge Amount |
1030910 |
Total Medical Medicare Allowed Amount |
467839.61 |
Total Medical Medicare Payment Amount |
353624.98 |
Total Medical Medicare Standardized Payment Amount |
369876.86 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
481 |
Number Of Beneficiaries Age 75 to 84 |
330 |
Number Of Beneficiaries Age Greater 84 |
154 |
Number Of Female Beneficiaries |
616 |
Number Of Male Beneficiaries |
447 |
Number Of Non Hispanic White Beneficiaries |
966 |
Number Of Black or African American Beneficiaries |
55 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
899 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
164 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.1212 |