| National Provider Identifier [NPI]: | 1831175819 |
| Last Name Of The Provider | GREENWALD |
| First Name Of The Provider | NANCY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 ROBBINS RD |
| Street Address 2 Of The Provider | #300 |
| City Of The Provider | BOISE |
| Zip Code Of The Provider | 837024565 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 5638 |
| Number Of Medicare Beneficiaries | 247 |
| Total Submitted Charge Amount | 174257.4 |
| Total Medicare Allowed Amount | 82199.6 |
| Total Medicare Payment Amount | 60592.06 |
| Total Medicare Standardized Payment Amount | 63883.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 5052 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 48398.4 |
| Total Drug Medicare AllowedAmount | 34265.1 |
| Total Drug Medicare PaymentAmount | 26810 |
| Total Drug Medicare Standardized Payment Amount | 26810 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 586 |
| Number Of Medicare Beneficiaries With Medical Services | 247 |
| Total Medical Submitted Charge Amount | 125859 |
| Total Medical Medicare Allowed Amount | 47934.5 |
| Total Medical Medicare Payment Amount | 33782.06 |
| Total Medical Medicare Standardized Payment Amount | 37073.96 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 79 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 144 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 230 |
| 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 | 168 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 79 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 53 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.7024 |