| National Provider Identifier [NPI]: | 1366414724 |
| Last Name Of The Provider | MCKEON |
| First Name Of The Provider | GLENN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 607 HIGHWAY 466 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LADY LAKE |
| Zip Code Of The Provider | 321596338 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 3153 |
| Number Of Medicare Beneficiaries | 647 |
| Total Submitted Charge Amount | 375660 |
| Total Medicare Allowed Amount | 193800.38 |
| Total Medicare Payment Amount | 135211.71 |
| Total Medicare Standardized Payment Amount | 161215.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 492 |
| Number Of Medicare Beneficiaries With Drug Services | 187 |
| Total Drug Submitted ChargeAmount | 17350 |
| Total Drug Medicare AllowedAmount | 10181.7 |
| Total Drug Medicare PaymentAmount | 8933.6 |
| Total Drug Medicare Standardized Payment Amount | 8933.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 2661 |
| Number Of Medicare Beneficiaries With Medical Services | 647 |
| Total Medical Submitted Charge Amount | 358310 |
| Total Medical Medicare Allowed Amount | 183618.68 |
| Total Medical Medicare Payment Amount | 126278.11 |
| Total Medical Medicare Standardized Payment Amount | 152281.71 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 335 |
| Number Of Beneficiaries Age 75 to 84 | 238 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 356 |
| Number Of Male Beneficiaries | 291 |
| Number Of Non Hispanic White Beneficiaries | 627 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 636 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.943 |