| National Provider Identifier [NPI]: | 1538191341 |
| Last Name Of The Provider | GLENN |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1540 SUNDAY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | RALEIGH |
| Zip Code Of The Provider | 276076000 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 1932 |
| Number Of Medicare Beneficiaries | 652 |
| Total Submitted Charge Amount | 401367.5 |
| Total Medicare Allowed Amount | 135874.21 |
| Total Medicare Payment Amount | 95858.85 |
| Total Medicare Standardized Payment Amount | 102244.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 574 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 4170.5 |
| Total Drug Medicare AllowedAmount | 1081.53 |
| Total Drug Medicare PaymentAmount | 828.92 |
| Total Drug Medicare Standardized Payment Amount | 828.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 1358 |
| Number Of Medicare Beneficiaries With Medical Services | 652 |
| Total Medical Submitted Charge Amount | 397197 |
| Total Medical Medicare Allowed Amount | 134792.68 |
| Total Medical Medicare Payment Amount | 95029.93 |
| Total Medical Medicare Standardized Payment Amount | 101415.26 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 144 |
| Number Of Beneficiaries Age 65 to 74 | 254 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 436 |
| Number Of Male Beneficiaries | 216 |
| Number Of Non Hispanic White Beneficiaries | 532 |
| Number Of Black or African American Beneficiaries | 98 |
| 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 | 549 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 103 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 1.2963 |