| National Provider Identifier [NPI]: | 1285623744 |
| Last Name Of The Provider | EVANS |
| First Name Of The Provider | GLENN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3207 COUNTRY CLUB DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | VALDOSTA |
| Zip Code Of The Provider | 316051029 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 115 |
| Number Of Services | 8578 |
| Number Of Medicare Beneficiaries | 1920 |
| Total Submitted Charge Amount | 1722596.25 |
| Total Medicare Allowed Amount | 559269.19 |
| Total Medicare Payment Amount | 420922.91 |
| Total Medicare Standardized Payment Amount | 435758 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 393 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 24779 |
| Total Drug Medicare AllowedAmount | 20257.14 |
| Total Drug Medicare PaymentAmount | 15616.81 |
| Total Drug Medicare Standardized Payment Amount | 15616.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 111 |
| Number Of Medical Services | 8185 |
| Number Of Medicare Beneficiaries With Medical Services | 1920 |
| Total Medical Submitted Charge Amount | 1697817.25 |
| Total Medical Medicare Allowed Amount | 539012.05 |
| Total Medical Medicare Payment Amount | 405306.1 |
| Total Medical Medicare Standardized Payment Amount | 420141.19 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 355 |
| Number Of Beneficiaries Age 65 to 74 | 683 |
| Number Of Beneficiaries Age 75 to 84 | 612 |
| Number Of Beneficiaries Age Greater 84 | 270 |
| Number Of Female Beneficiaries | 1025 |
| Number Of Male Beneficiaries | 895 |
| Number Of Non Hispanic White Beneficiaries | 1457 |
| Number Of Black or African American Beneficiaries | 420 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1378 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 542 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6953 |