| National Provider Identifier [NPI]: | 1730151119 |
| Last Name Of The Provider | GLASSMAN |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4660 KENMORE AVE |
| Street Address 2 Of The Provider | SUITE 500 |
| City Of The Provider | ALEXANDRIA |
| Zip Code Of The Provider | 223041313 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 11960 |
| Number Of Medicare Beneficiaries | 1990 |
| Total Submitted Charge Amount | 1145937.1 |
| Total Medicare Allowed Amount | 1048236.23 |
| Total Medicare Payment Amount | 771117.27 |
| Total Medicare Standardized Payment Amount | 771184.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 115 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 346.2 |
| Total Drug Medicare AllowedAmount | 203.61 |
| Total Drug Medicare PaymentAmount | 153.15 |
| Total Drug Medicare Standardized Payment Amount | 153.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 11845 |
| Number Of Medicare Beneficiaries With Medical Services | 1990 |
| Total Medical Submitted Charge Amount | 1145590.9 |
| Total Medical Medicare Allowed Amount | 1048032.62 |
| Total Medical Medicare Payment Amount | 770964.12 |
| Total Medical Medicare Standardized Payment Amount | 771030.86 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 123 |
| Number Of Beneficiaries Age 65 to 74 | 1046 |
| Number Of Beneficiaries Age 75 to 84 | 558 |
| Number Of Beneficiaries Age Greater 84 | 263 |
| Number Of Female Beneficiaries | 887 |
| Number Of Male Beneficiaries | 1103 |
| Number Of Non Hispanic White Beneficiaries | 1672 |
| Number Of Black or African American Beneficiaries | 126 |
| Number Of AsianPacific Islander Beneficiaries | 66 |
| Number Of Hispanic Beneficiaries | 64 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1795 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 195 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8776 |