| National Provider Identifier [NPI]: | 1720254816 |
| Last Name Of The Provider | TOLLEY |
| First Name Of The Provider | GLENNA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | RN FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 680 FM 517 RD W |
| Street Address 2 Of The Provider | |
| City Of The Provider | DICKINSON |
| Zip Code Of The Provider | 775393904 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 2526 |
| Number Of Medicare Beneficiaries | 335 |
| Total Submitted Charge Amount | 401546 |
| Total Medicare Allowed Amount | 243511.19 |
| Total Medicare Payment Amount | 182377.65 |
| Total Medicare Standardized Payment Amount | 215417.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 87 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 2190 |
| Total Drug Medicare AllowedAmount | 1332.74 |
| Total Drug Medicare PaymentAmount | 1305.51 |
| Total Drug Medicare Standardized Payment Amount | 1305.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 2439 |
| Number Of Medicare Beneficiaries With Medical Services | 335 |
| Total Medical Submitted Charge Amount | 399356 |
| Total Medical Medicare Allowed Amount | 242178.45 |
| Total Medical Medicare Payment Amount | 181072.14 |
| Total Medical Medicare Standardized Payment Amount | 214111.67 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 58 |
| Number Of Beneficiaries Age 75 to 84 | 101 |
| Number Of Beneficiaries Age Greater 84 | 135 |
| Number Of Female Beneficiaries | 231 |
| Number Of Male Beneficiaries | 104 |
| Number Of Non Hispanic White Beneficiaries | 255 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 258 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 62 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 48 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 67 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.5186 |