| National Provider Identifier [NPI]: | 1255337671 |
| Last Name Of The Provider | GLINICK |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 HIGHLAND AVE |
| Street Address 2 Of The Provider | STE 301 |
| City Of The Provider | PROVIDENCE |
| Zip Code Of The Provider | 029062753 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 2860 |
| Number Of Medicare Beneficiaries | 714 |
| Total Submitted Charge Amount | 261776.05 |
| Total Medicare Allowed Amount | 168034.77 |
| Total Medicare Payment Amount | 123374.3 |
| Total Medicare Standardized Payment Amount | 118822.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 3916.65 |
| Total Drug Medicare AllowedAmount | 2970.91 |
| Total Drug Medicare PaymentAmount | 2329.2 |
| Total Drug Medicare Standardized Payment Amount | 2329.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 2842 |
| Number Of Medicare Beneficiaries With Medical Services | 714 |
| Total Medical Submitted Charge Amount | 257859.4 |
| Total Medical Medicare Allowed Amount | 165063.86 |
| Total Medical Medicare Payment Amount | 121045.1 |
| Total Medical Medicare Standardized Payment Amount | 116493.75 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 320 |
| Number Of Beneficiaries Age 75 to 84 | 215 |
| Number Of Beneficiaries Age Greater 84 | 158 |
| Number Of Female Beneficiaries | 316 |
| Number Of Male Beneficiaries | 398 |
| Number Of Non Hispanic White Beneficiaries | 694 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 691 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0112 |