| National Provider Identifier [NPI]: | 1487733259 |
| Last Name Of The Provider | GLENN |
| First Name Of The Provider | BRYAN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 700 W KINGSHIGHWAY STE A |
| Street Address 2 Of The Provider | |
| City Of The Provider | PARAGOULD |
| Zip Code Of The Provider | 724505929 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 2481 |
| Number Of Medicare Beneficiaries | 729 |
| Total Submitted Charge Amount | 233436 |
| Total Medicare Allowed Amount | 126907.34 |
| Total Medicare Payment Amount | 91545.51 |
| Total Medicare Standardized Payment Amount | 104225.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 135 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 203.8 |
| Total Drug Medicare AllowedAmount | 129.39 |
| Total Drug Medicare PaymentAmount | 99.99 |
| Total Drug Medicare Standardized Payment Amount | 99.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 2346 |
| Number Of Medicare Beneficiaries With Medical Services | 729 |
| Total Medical Submitted Charge Amount | 233232.2 |
| Total Medical Medicare Allowed Amount | 126777.95 |
| Total Medical Medicare Payment Amount | 91445.52 |
| Total Medical Medicare Standardized Payment Amount | 104125.52 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 130 |
| Number Of Beneficiaries Age 65 to 74 | 252 |
| Number Of Beneficiaries Age 75 to 84 | 224 |
| Number Of Beneficiaries Age Greater 84 | 123 |
| Number Of Female Beneficiaries | 454 |
| Number Of Male Beneficiaries | 275 |
| 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 | 513 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 216 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3726 |