| National Provider Identifier [NPI]: | 1245276419 |
| Last Name Of The Provider | GLICK |
| First Name Of The Provider | SETH |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 39TH & MARKET ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 19104 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 8366 |
| Number Of Medicare Beneficiaries | 3894 |
| Total Submitted Charge Amount | 509507 |
| Total Medicare Allowed Amount | 168848.84 |
| Total Medicare Payment Amount | 123639.47 |
| Total Medicare Standardized Payment Amount | 118134.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 89 |
| Number Of Medical Services | 8366 |
| Number Of Medicare Beneficiaries With Medical Services | 3894 |
| Total Medical Submitted Charge Amount | 509507 |
| Total Medical Medicare Allowed Amount | 168848.84 |
| Total Medical Medicare Payment Amount | 123639.47 |
| Total Medical Medicare Standardized Payment Amount | 118134.62 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 1029 |
| Number Of Beneficiaries Age 65 to 74 | 1514 |
| Number Of Beneficiaries Age 75 to 84 | 922 |
| Number Of Beneficiaries Age Greater 84 | 429 |
| Number Of Female Beneficiaries | 2175 |
| Number Of Male Beneficiaries | 1719 |
| Number Of Non Hispanic White Beneficiaries | 1838 |
| Number Of Black or African American Beneficiaries | 1866 |
| Number Of AsianPacific Islander Beneficiaries | 67 |
| Number Of Hispanic Beneficiaries | 66 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2523 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1371 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9323 |