| National Provider Identifier [NPI]: | 1720023070 |
| Last Name Of The Provider | PICKENS |
| First Name Of The Provider | GLYNN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 890 ROCKWALL PKWY |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | ROCKWALL |
| Zip Code Of The Provider | 750326872 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 102 |
| Number Of Services | 6243 |
| Number Of Medicare Beneficiaries | 1052 |
| Total Submitted Charge Amount | 800721.2 |
| Total Medicare Allowed Amount | 399499.46 |
| Total Medicare Payment Amount | 300023.01 |
| Total Medicare Standardized Payment Amount | 307225.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 886 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 112544.2 |
| Total Drug Medicare AllowedAmount | 56299.94 |
| Total Drug Medicare PaymentAmount | 44010.84 |
| Total Drug Medicare Standardized Payment Amount | 44010.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 5357 |
| Number Of Medicare Beneficiaries With Medical Services | 1052 |
| Total Medical Submitted Charge Amount | 688177 |
| Total Medical Medicare Allowed Amount | 343199.52 |
| Total Medical Medicare Payment Amount | 256012.17 |
| Total Medical Medicare Standardized Payment Amount | 263215.11 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 448 |
| Number Of Beneficiaries Age 75 to 84 | 393 |
| Number Of Beneficiaries Age Greater 84 | 136 |
| Number Of Female Beneficiaries | 218 |
| Number Of Male Beneficiaries | 834 |
| Number Of Non Hispanic White Beneficiaries | 895 |
| Number Of Black or African American Beneficiaries | 61 |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 936 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 116 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3333 |