| National Provider Identifier [NPI]: | 1760454821 |
| Last Name Of The Provider | GREEN |
| First Name Of The Provider | SCOTT |
| 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 | 22 N 27TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT DODGE |
| Zip Code Of The Provider | 505014331 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 4209 |
| Number Of Medicare Beneficiaries | 1103 |
| Total Submitted Charge Amount | 346967.36 |
| Total Medicare Allowed Amount | 185866.44 |
| Total Medicare Payment Amount | 127729.1 |
| Total Medicare Standardized Payment Amount | 133930.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 115 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 285.72 |
| Total Drug Medicare AllowedAmount | 207.03 |
| Total Drug Medicare PaymentAmount | 117.63 |
| Total Drug Medicare Standardized Payment Amount | 117.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 4094 |
| Number Of Medicare Beneficiaries With Medical Services | 1103 |
| Total Medical Submitted Charge Amount | 346681.64 |
| Total Medical Medicare Allowed Amount | 185659.41 |
| Total Medical Medicare Payment Amount | 127611.47 |
| Total Medical Medicare Standardized Payment Amount | 133812.61 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 370 |
| Number Of Beneficiaries Age 75 to 84 | 400 |
| Number Of Beneficiaries Age Greater 84 | 263 |
| Number Of Female Beneficiaries | 517 |
| Number Of Male Beneficiaries | 586 |
| Number Of Non Hispanic White Beneficiaries | 1092 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 993 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0116 |