| National Provider Identifier [NPI]: | 1588639678 |
| Last Name Of The Provider | GLOVER |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 842 SUNSET LAKE BLVD |
| Street Address 2 Of The Provider | SUITE 401 |
| City Of The Provider | VENICE |
| Zip Code Of The Provider | 342927551 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 5378 |
| Number Of Medicare Beneficiaries | 1028 |
| Total Submitted Charge Amount | 513835 |
| Total Medicare Allowed Amount | 309563.62 |
| Total Medicare Payment Amount | 225234.88 |
| Total Medicare Standardized Payment Amount | 226861.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 400 |
| Number Of Medicare Beneficiaries With Drug Services | 270 |
| Total Drug Submitted ChargeAmount | 17098 |
| Total Drug Medicare AllowedAmount | 11584.95 |
| Total Drug Medicare PaymentAmount | 11196.42 |
| Total Drug Medicare Standardized Payment Amount | 11196.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 4978 |
| Number Of Medicare Beneficiaries With Medical Services | 1028 |
| Total Medical Submitted Charge Amount | 496737 |
| Total Medical Medicare Allowed Amount | 297978.67 |
| Total Medical Medicare Payment Amount | 214038.46 |
| Total Medical Medicare Standardized Payment Amount | 215665.1 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 385 |
| Number Of Beneficiaries Age 75 to 84 | 405 |
| Number Of Beneficiaries Age Greater 84 | 225 |
| Number Of Female Beneficiaries | 517 |
| Number Of Male Beneficiaries | 511 |
| Number Of Non Hispanic White Beneficiaries | 1006 |
| 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 | 1003 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1424 |