| National Provider Identifier [NPI]: | 1649582131 |
| Last Name Of The Provider | GLAWS |
| First Name Of The Provider | SHANNON |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 21475 RIDGETOP CIR STE 150 |
| Street Address 2 Of The Provider | |
| City Of The Provider | STERLING |
| Zip Code Of The Provider | 201666580 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 281 |
| Number Of Medicare Beneficiaries | 106 |
| Total Submitted Charge Amount | 445126.8 |
| Total Medicare Allowed Amount | 25278.18 |
| Total Medicare Payment Amount | 19230.2 |
| Total Medicare Standardized Payment Amount | 21087.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 61 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 4800 |
| Total Drug Medicare AllowedAmount | 2110.63 |
| Total Drug Medicare PaymentAmount | 1649.03 |
| Total Drug Medicare Standardized Payment Amount | 1649.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 220 |
| Number Of Medicare Beneficiaries With Medical Services | 106 |
| Total Medical Submitted Charge Amount | 440326.8 |
| Total Medical Medicare Allowed Amount | 23167.55 |
| Total Medical Medicare Payment Amount | 17581.17 |
| Total Medical Medicare Standardized Payment Amount | 19438.73 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 59 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 66 |
| Number Of Male Beneficiaries | 40 |
| Number Of Non Hispanic White Beneficiaries | 89 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9036 |