| National Provider Identifier [NPI]: | 1104897560 |
| Last Name Of The Provider | GLICKMAN |
| First Name Of The Provider | MARC |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 397 LITTLE NECK RD |
| Street Address 2 Of The Provider | STE 100 3300 SOUTH BLDG |
| City Of The Provider | VIRGINIA BEACH |
| Zip Code Of The Provider | 23452 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 4217 |
| Number Of Medicare Beneficiaries | 1825 |
| Total Submitted Charge Amount | 938708 |
| Total Medicare Allowed Amount | 303587.11 |
| Total Medicare Payment Amount | 233243.58 |
| Total Medicare Standardized Payment Amount | 241864.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1607 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 2003 |
| Total Drug Medicare AllowedAmount | 557.78 |
| Total Drug Medicare PaymentAmount | 437.27 |
| Total Drug Medicare Standardized Payment Amount | 437.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 115 |
| Number Of Medical Services | 2610 |
| Number Of Medicare Beneficiaries With Medical Services | 1825 |
| Total Medical Submitted Charge Amount | 936705 |
| Total Medical Medicare Allowed Amount | 303029.33 |
| Total Medical Medicare Payment Amount | 232806.31 |
| Total Medical Medicare Standardized Payment Amount | 241427.39 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 313 |
| Number Of Beneficiaries Age 65 to 74 | 637 |
| Number Of Beneficiaries Age 75 to 84 | 593 |
| Number Of Beneficiaries Age Greater 84 | 282 |
| Number Of Female Beneficiaries | 975 |
| Number Of Male Beneficiaries | 850 |
| Number Of Non Hispanic White Beneficiaries | 1155 |
| Number Of Black or African American Beneficiaries | 600 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1461 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 364 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.5339 |