| National Provider Identifier [NPI]: | 1275567828 |
| Last Name Of The Provider | GLEESPEN |
| First Name Of The Provider | MARTIN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1290 S MAIN ST |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | CHELSEA |
| Zip Code Of The Provider | 481181454 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 1709 |
| Number Of Medicare Beneficiaries | 331 |
| Total Submitted Charge Amount | 170016 |
| Total Medicare Allowed Amount | 113160.65 |
| Total Medicare Payment Amount | 76957.95 |
| Total Medicare Standardized Payment Amount | 76834.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 126 |
| Number Of Medicare Beneficiaries With Drug Services | 99 |
| Total Drug Submitted ChargeAmount | 4694 |
| Total Drug Medicare AllowedAmount | 3127.12 |
| Total Drug Medicare PaymentAmount | 2798.3 |
| Total Drug Medicare Standardized Payment Amount | 2798.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 1583 |
| Number Of Medicare Beneficiaries With Medical Services | 331 |
| Total Medical Submitted Charge Amount | 165322 |
| Total Medical Medicare Allowed Amount | 110033.53 |
| Total Medical Medicare Payment Amount | 74159.65 |
| Total Medical Medicare Standardized Payment Amount | 74036.19 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 153 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 166 |
| Number Of Male Beneficiaries | 165 |
| Number Of Non Hispanic White Beneficiaries | 320 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 301 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1681 |