| National Provider Identifier [NPI]: | 1821240615 |
| Last Name Of The Provider | GLISKY |
| First Name Of The Provider | NATALIA |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 29275 NORTHWESTERN HWY |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | SOUTHFIELD |
| Zip Code Of The Provider | 480341044 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 5205 |
| Number Of Medicare Beneficiaries | 27 |
| Total Submitted Charge Amount | 241834.25 |
| Total Medicare Allowed Amount | 33156.46 |
| Total Medicare Payment Amount | 25736.51 |
| Total Medicare Standardized Payment Amount | 23477.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 4967 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 68382.25 |
| Total Drug Medicare AllowedAmount | 9597.16 |
| Total Drug Medicare PaymentAmount | 7524.24 |
| Total Drug Medicare Standardized Payment Amount | 7524.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 238 |
| Number Of Medicare Beneficiaries With Medical Services | 27 |
| Total Medical Submitted Charge Amount | 173452 |
| Total Medical Medicare Allowed Amount | 23559.3 |
| Total Medical Medicare Payment Amount | 18212.27 |
| Total Medical Medicare Standardized Payment Amount | 15952.86 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 0 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1495 |