| National Provider Identifier [NPI]: | 1154387413 |
| Last Name Of The Provider | GLASSBERG |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | LASER SKIN CARE CENTER |
| Street Address 2 Of The Provider | 3918 LONG BEACH BOULEVARD SUITE200 |
| City Of The Provider | LONG BEACH |
| Zip Code Of The Provider | 908072615 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 104 |
| Number Of Services | 8455 |
| Number Of Medicare Beneficiaries | 1217 |
| Total Submitted Charge Amount | 1968372 |
| Total Medicare Allowed Amount | 992143.91 |
| Total Medicare Payment Amount | 751901.72 |
| Total Medicare Standardized Payment Amount | 653811.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 80 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 7560 |
| Total Drug Medicare AllowedAmount | 5437.26 |
| Total Drug Medicare PaymentAmount | 4116.33 |
| Total Drug Medicare Standardized Payment Amount | 4116.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 8375 |
| Number Of Medicare Beneficiaries With Medical Services | 1217 |
| Total Medical Submitted Charge Amount | 1960812 |
| Total Medical Medicare Allowed Amount | 986706.65 |
| Total Medical Medicare Payment Amount | 747785.39 |
| Total Medical Medicare Standardized Payment Amount | 649695.33 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 519 |
| Number Of Beneficiaries Age 75 to 84 | 433 |
| Number Of Beneficiaries Age Greater 84 | 226 |
| Number Of Female Beneficiaries | 600 |
| Number Of Male Beneficiaries | 617 |
| Number Of Non Hispanic White Beneficiaries | 1123 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1150 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| 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 | 1.004 |