| National Provider Identifier [NPI]: | 1144248501 |
| Last Name Of The Provider | GLOVER |
| First Name Of The Provider | KATRINA |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 721 CLINIC DR |
| Street Address 2 Of The Provider | STE A |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757012043 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 134 |
| Number Of Services | 90089 |
| Number Of Medicare Beneficiaries | 605 |
| Total Submitted Charge Amount | 3458009 |
| Total Medicare Allowed Amount | 1500799.75 |
| Total Medicare Payment Amount | 1170085.51 |
| Total Medicare Standardized Payment Amount | 1183819.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 70 |
| Number Of Drug Services | 81240 |
| Number Of Medicare Beneficiaries With Drug Services | 255 |
| Total Drug Submitted ChargeAmount | 2729261 |
| Total Drug Medicare AllowedAmount | 1144792.08 |
| Total Drug Medicare PaymentAmount | 889144.21 |
| Total Drug Medicare Standardized Payment Amount | 889144.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 8849 |
| Number Of Medicare Beneficiaries With Medical Services | 605 |
| Total Medical Submitted Charge Amount | 728748 |
| Total Medical Medicare Allowed Amount | 356007.67 |
| Total Medical Medicare Payment Amount | 280941.3 |
| Total Medical Medicare Standardized Payment Amount | 294675.45 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 83 |
| Number Of Beneficiaries Age 65 to 74 | 258 |
| Number Of Beneficiaries Age 75 to 84 | 197 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 340 |
| Number Of Male Beneficiaries | 265 |
| Number Of Non Hispanic White Beneficiaries | 504 |
| Number Of Black or African American Beneficiaries | 83 |
| 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 | 478 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 47 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.1402 |