| National Provider Identifier [NPI]: | 1013947829 |
| Last Name Of The Provider | GREEN |
| First Name Of The Provider | LINDA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4727 SAINT ANTOINE ST |
| Street Address 2 Of The Provider | SUITE 211 |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482011461 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 589 |
| Number Of Medicare Beneficiaries | 107 |
| Total Submitted Charge Amount | 79610 |
| Total Medicare Allowed Amount | 63262.09 |
| Total Medicare Payment Amount | 49444.84 |
| Total Medicare Standardized Payment Amount | 48475.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 51 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 1752 |
| Total Drug Medicare AllowedAmount | 290.92 |
| Total Drug Medicare PaymentAmount | 275.2 |
| Total Drug Medicare Standardized Payment Amount | 275.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 538 |
| Number Of Medicare Beneficiaries With Medical Services | 107 |
| Total Medical Submitted Charge Amount | 77858 |
| Total Medical Medicare Allowed Amount | 62971.17 |
| Total Medical Medicare Payment Amount | 49169.64 |
| Total Medical Medicare Standardized Payment Amount | 48200.59 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 29 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 85 |
| Number Of Male Beneficiaries | 22 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 30 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6958 |