| National Provider Identifier [NPI]: | 1730299074 |
| Last Name Of The Provider | GREENWELL |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 526 W GENESEE ST |
| Street Address 2 Of The Provider | UNIT #3 |
| City Of The Provider | FRANKENMUTH |
| Zip Code Of The Provider | 487341701 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 3802 |
| Number Of Medicare Beneficiaries | 515 |
| Total Submitted Charge Amount | 339119 |
| Total Medicare Allowed Amount | 263532.51 |
| Total Medicare Payment Amount | 191396.55 |
| Total Medicare Standardized Payment Amount | 198077.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 157 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 5022 |
| Total Drug Medicare AllowedAmount | 4035.67 |
| Total Drug Medicare PaymentAmount | 3921.87 |
| Total Drug Medicare Standardized Payment Amount | 3921.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 3645 |
| Number Of Medicare Beneficiaries With Medical Services | 515 |
| Total Medical Submitted Charge Amount | 334097 |
| Total Medical Medicare Allowed Amount | 259496.84 |
| Total Medical Medicare Payment Amount | 187474.68 |
| Total Medical Medicare Standardized Payment Amount | 194155.85 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 218 |
| Number Of Beneficiaries Age 75 to 84 | 148 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 295 |
| Number Of Male Beneficiaries | 220 |
| Number Of Non Hispanic White Beneficiaries | 495 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 487 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0905 |