| National Provider Identifier [NPI]: | 1255423158 |
| Last Name Of The Provider | GREEN |
| First Name Of The Provider | PATRICIA |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1321 NE 99TH AVE |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972209440 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 270 |
| Number Of Medicare Beneficiaries | 102 |
| Total Submitted Charge Amount | 65703.5 |
| Total Medicare Allowed Amount | 18269.87 |
| Total Medicare Payment Amount | 13183.36 |
| Total Medicare Standardized Payment Amount | 15459.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 974 |
| Total Drug Medicare AllowedAmount | 632.78 |
| Total Drug Medicare PaymentAmount | 616.66 |
| Total Drug Medicare Standardized Payment Amount | 616.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 255 |
| Number Of Medicare Beneficiaries With Medical Services | 102 |
| Total Medical Submitted Charge Amount | 64729.5 |
| Total Medical Medicare Allowed Amount | 17637.09 |
| Total Medical Medicare Payment Amount | 12566.7 |
| Total Medical Medicare Standardized Payment Amount | 14842.5 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 38 |
| Number Of Beneficiaries Age 75 to 84 | 29 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 86 |
| Number Of Male Beneficiaries | 16 |
| Number Of Non Hispanic White Beneficiaries | 83 |
| Number Of Black or African American Beneficiaries | |
| 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 | 72 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.259 |