| National Provider Identifier [NPI]: | 1003919994 |
| Last Name Of The Provider | GREESON |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120 E BEAUREGARD AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN ANGELO |
| Zip Code Of The Provider | 769035919 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 914 |
| Number Of Medicare Beneficiaries | 259 |
| Total Submitted Charge Amount | 87144.69 |
| Total Medicare Allowed Amount | 48914.86 |
| Total Medicare Payment Amount | 34225.14 |
| Total Medicare Standardized Payment Amount | 35780.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 189 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 2624.47 |
| Total Drug Medicare AllowedAmount | 1477.13 |
| Total Drug Medicare PaymentAmount | 1158.08 |
| Total Drug Medicare Standardized Payment Amount | 1158.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 725 |
| Number Of Medicare Beneficiaries With Medical Services | 259 |
| Total Medical Submitted Charge Amount | 84520.22 |
| Total Medical Medicare Allowed Amount | 47437.73 |
| Total Medical Medicare Payment Amount | 33067.06 |
| Total Medical Medicare Standardized Payment Amount | 34622.38 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 124 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 128 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 186 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 228 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1279 |