National Provider Identifier [NPI]: |
1588696306 |
Last Name Of The Provider |
GLICKMAN |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D., F.A.C.P. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1800 ROCKAWAY AVE |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
HEWLETT |
Zip Code Of The Provider |
115571665 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
6651 |
Number Of Medicare Beneficiaries |
269 |
Total Submitted Charge Amount |
341120 |
Total Medicare Allowed Amount |
174726.59 |
Total Medicare Payment Amount |
147988.69 |
Total Medicare Standardized Payment Amount |
141724.34 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
67 |
Number Of Medicare Beneficiaries With Drug Services |
63 |
Total Drug Submitted ChargeAmount |
3665 |
Total Drug Medicare AllowedAmount |
1853.39 |
Total Drug Medicare PaymentAmount |
1816.29 |
Total Drug Medicare Standardized Payment Amount |
1816.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
59 |
Number Of Medical Services |
6584 |
Number Of Medicare Beneficiaries With Medical Services |
269 |
Total Medical Submitted Charge Amount |
337455 |
Total Medical Medicare Allowed Amount |
172873.2 |
Total Medical Medicare Payment Amount |
146172.4 |
Total Medical Medicare Standardized Payment Amount |
139908.05 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
126 |
Number Of Male Beneficiaries |
143 |
Number Of Non Hispanic White Beneficiaries |
251 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9571 |