| National Provider Identifier [NPI]: | 1346437506 |
| Last Name Of The Provider | GLICK |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4495 ROOSEVELT BLVD STE 316 |
| Street Address 2 Of The Provider | CREDENTIALING DEPARTMENT |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322103356 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 2902 |
| Number Of Medicare Beneficiaries | 467 |
| Total Submitted Charge Amount | 304506 |
| Total Medicare Allowed Amount | 175698.69 |
| Total Medicare Payment Amount | 122203.9 |
| Total Medicare Standardized Payment Amount | 126507.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 391 |
| Number Of Medicare Beneficiaries With Drug Services | 154 |
| Total Drug Submitted ChargeAmount | 13730 |
| Total Drug Medicare AllowedAmount | 6648.49 |
| Total Drug Medicare PaymentAmount | 6388.07 |
| Total Drug Medicare Standardized Payment Amount | 6388.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 2511 |
| Number Of Medicare Beneficiaries With Medical Services | 467 |
| Total Medical Submitted Charge Amount | 290776 |
| Total Medical Medicare Allowed Amount | 169050.2 |
| Total Medical Medicare Payment Amount | 115815.83 |
| Total Medical Medicare Standardized Payment Amount | 120119.92 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 234 |
| Number Of Beneficiaries Age 75 to 84 | 115 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 263 |
| Number Of Male Beneficiaries | 204 |
| Number Of Non Hispanic White Beneficiaries | 401 |
| Number Of Black or African American Beneficiaries | 47 |
| 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 | 419 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1583 |