| National Provider Identifier [NPI]: | 1285655738 |
| Last Name Of The Provider | PAUL |
| First Name Of The Provider | GLENN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | RPA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 N. VILLAGE AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCKVILLE CENTRE |
| Zip Code Of The Provider | 11571 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 1423 |
| Number Of Medicare Beneficiaries | 534 |
| Total Submitted Charge Amount | 201408 |
| Total Medicare Allowed Amount | 54703.66 |
| Total Medicare Payment Amount | 42458.18 |
| Total Medicare Standardized Payment Amount | 49965.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 1423 |
| Number Of Medicare Beneficiaries With Medical Services | 534 |
| Total Medical Submitted Charge Amount | 201408 |
| Total Medical Medicare Allowed Amount | 54703.66 |
| Total Medical Medicare Payment Amount | 42458.18 |
| Total Medical Medicare Standardized Payment Amount | 49965.17 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 296 |
| Number Of Beneficiaries Age 75 to 84 | 131 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 230 |
| Number Of Male Beneficiaries | 304 |
| Number Of Non Hispanic White Beneficiaries | 450 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 49 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 470 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.9533 |