National Provider Identifier [NPI]: |
1356399935 |
Last Name Of The Provider |
GLICK |
First Name Of The Provider |
ANDREW |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2000 FOULK ROAD |
Street Address 2 Of The Provider |
SUITE F |
City Of The Provider |
WILMINGTON |
Zip Code Of The Provider |
19810 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
86 |
Number Of Services |
4571 |
Number Of Medicare Beneficiaries |
1799 |
Total Submitted Charge Amount |
1391226.06 |
Total Medicare Allowed Amount |
523253.15 |
Total Medicare Payment Amount |
385429.08 |
Total Medicare Standardized Payment Amount |
383191.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
775 |
Number Of Medicare Beneficiaries With Drug Services |
108 |
Total Drug Submitted ChargeAmount |
339894.08 |
Total Drug Medicare AllowedAmount |
106276.42 |
Total Drug Medicare PaymentAmount |
81195.46 |
Total Drug Medicare Standardized Payment Amount |
81195.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
80 |
Number Of Medical Services |
3796 |
Number Of Medicare Beneficiaries With Medical Services |
1799 |
Total Medical Submitted Charge Amount |
1051331.98 |
Total Medical Medicare Allowed Amount |
416976.73 |
Total Medical Medicare Payment Amount |
304233.62 |
Total Medical Medicare Standardized Payment Amount |
301996.04 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
782 |
Number Of Beneficiaries Age 75 to 84 |
664 |
Number Of Beneficiaries Age Greater 84 |
255 |
Number Of Female Beneficiaries |
290 |
Number Of Male Beneficiaries |
1509 |
Number Of Non Hispanic White Beneficiaries |
1535 |
Number Of Black or African American Beneficiaries |
184 |
Number Of AsianPacific Islander Beneficiaries |
22 |
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
33 |
Number Of Beneficiaries With Medicare Only Entitlement |
1693 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
31 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.2294 |