| National Provider Identifier [NPI]: | 1053301655 |
| Last Name Of The Provider | GREEN |
| First Name Of The Provider | HOWARD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120A BUTLER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST PALM BEACH |
| Zip Code Of The Provider | 33407 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 12014 |
| Number Of Medicare Beneficiaries | 1692 |
| Total Submitted Charge Amount | 1737016.98 |
| Total Medicare Allowed Amount | 635481.68 |
| Total Medicare Payment Amount | 468318.57 |
| Total Medicare Standardized Payment Amount | 426798.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 14 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 1940 |
| Total Drug Medicare AllowedAmount | 1807.15 |
| Total Drug Medicare PaymentAmount | 1416.8 |
| Total Drug Medicare Standardized Payment Amount | 1416.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 12000 |
| Number Of Medicare Beneficiaries With Medical Services | 1692 |
| Total Medical Submitted Charge Amount | 1735076.98 |
| Total Medical Medicare Allowed Amount | 633674.53 |
| Total Medical Medicare Payment Amount | 466901.77 |
| Total Medical Medicare Standardized Payment Amount | 425381.77 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 773 |
| Number Of Beneficiaries Age 75 to 84 | 617 |
| Number Of Beneficiaries Age Greater 84 | 270 |
| Number Of Female Beneficiaries | 841 |
| Number Of Male Beneficiaries | 851 |
| Number Of Non Hispanic White Beneficiaries | 1623 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1643 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0365 |