| National Provider Identifier [NPI]: | 1780689091 |
| Last Name Of The Provider | GREEN |
| First Name Of The Provider | LOUIS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 739 IRVING AVE |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | SYRACUSE |
| Zip Code Of The Provider | 132101668 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 3585 |
| Number Of Medicare Beneficiaries | 463 |
| Total Submitted Charge Amount | 303451.76 |
| Total Medicare Allowed Amount | 176469.23 |
| Total Medicare Payment Amount | 125723.52 |
| Total Medicare Standardized Payment Amount | 132040.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 1281 |
| Number Of Medicare Beneficiaries With Drug Services | 182 |
| Total Drug Submitted ChargeAmount | 46475 |
| Total Drug Medicare AllowedAmount | 20769.95 |
| Total Drug Medicare PaymentAmount | 17240.15 |
| Total Drug Medicare Standardized Payment Amount | 17240.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 2304 |
| Number Of Medicare Beneficiaries With Medical Services | 463 |
| Total Medical Submitted Charge Amount | 256976.76 |
| Total Medical Medicare Allowed Amount | 155699.28 |
| Total Medical Medicare Payment Amount | 108483.37 |
| Total Medical Medicare Standardized Payment Amount | 114800.24 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 176 |
| Number Of Beneficiaries Age 75 to 84 | 161 |
| Number Of Beneficiaries Age Greater 84 | 105 |
| Number Of Female Beneficiaries | 252 |
| Number Of Male Beneficiaries | 211 |
| Number Of Non Hispanic White Beneficiaries | 413 |
| Number Of Black or African American Beneficiaries | 30 |
| 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 | 437 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 0.9967 |