| National Provider Identifier [NPI]: | 1649247180 |
| Last Name Of The Provider | HEGGIE |
| First Name Of The Provider | GLEN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 N PARK ST |
| Street Address 2 Of The Provider | WEST MICHIGAN CANCER CENTER |
| City Of The Provider | KALAMAZOO |
| Zip Code Of The Provider | 490073731 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 9831 |
| Number Of Medicare Beneficiaries | 334 |
| Total Submitted Charge Amount | 982701 |
| Total Medicare Allowed Amount | 296402 |
| Total Medicare Payment Amount | 226762.54 |
| Total Medicare Standardized Payment Amount | 227902.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 39 |
| Number Of Drug Services | 8613 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 821681 |
| Total Drug Medicare AllowedAmount | 245156.72 |
| Total Drug Medicare PaymentAmount | 187816.7 |
| Total Drug Medicare Standardized Payment Amount | 187816.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 1218 |
| Number Of Medicare Beneficiaries With Medical Services | 334 |
| Total Medical Submitted Charge Amount | 161020 |
| Total Medical Medicare Allowed Amount | 51245.28 |
| Total Medical Medicare Payment Amount | 38945.84 |
| Total Medical Medicare Standardized Payment Amount | 40085.35 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 123 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 176 |
| Number Of Male Beneficiaries | 158 |
| Number Of Non Hispanic White Beneficiaries | 296 |
| Number Of Black or African American Beneficiaries | 24 |
| 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 | 256 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 78 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 38 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.2073 |