| National Provider Identifier [NPI]: | 1740263953 |
| Last Name Of The Provider | GLEASON |
| First Name Of The Provider | TERRENCE |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1810 MESQUITE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKE HAVASU CITY |
| Zip Code Of The Provider | 864035886 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 6532 |
| Number Of Medicare Beneficiaries | 1590 |
| Total Submitted Charge Amount | 1418479.38 |
| Total Medicare Allowed Amount | 638930.51 |
| Total Medicare Payment Amount | 469060.27 |
| Total Medicare Standardized Payment Amount | 473568.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 2143 |
| Number Of Medicare Beneficiaries With Drug Services | 124 |
| Total Drug Submitted ChargeAmount | 458002 |
| Total Drug Medicare AllowedAmount | 133021 |
| Total Drug Medicare PaymentAmount | 103368.26 |
| Total Drug Medicare Standardized Payment Amount | 103368.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 4389 |
| Number Of Medicare Beneficiaries With Medical Services | 1590 |
| Total Medical Submitted Charge Amount | 960477.38 |
| Total Medical Medicare Allowed Amount | 505909.51 |
| Total Medical Medicare Payment Amount | 365692.01 |
| Total Medical Medicare Standardized Payment Amount | 370200.04 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 685 |
| Number Of Beneficiaries Age 75 to 84 | 642 |
| Number Of Beneficiaries Age Greater 84 | 205 |
| Number Of Female Beneficiaries | 315 |
| Number Of Male Beneficiaries | 1275 |
| Number Of Non Hispanic White Beneficiaries | 1490 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 59 |
| Number Of American Indian Alaska Native Beneficiaries | 18 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1518 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1536 |