| National Provider Identifier [NPI]: | 1154329944 |
| Last Name Of The Provider | GLASSMIRE |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | PAC |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6122 TORRESDALE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191353718 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 1048 |
| Number Of Medicare Beneficiaries | 118 |
| Total Submitted Charge Amount | 124480 |
| Total Medicare Allowed Amount | 76969.5 |
| Total Medicare Payment Amount | 60016.63 |
| Total Medicare Standardized Payment Amount | 67669.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 83 |
| Number Of Medicare Beneficiaries With Drug Services | 75 |
| Total Drug Submitted ChargeAmount | 3640 |
| Total Drug Medicare AllowedAmount | 1503.4 |
| Total Drug Medicare PaymentAmount | 1472.97 |
| Total Drug Medicare Standardized Payment Amount | 1472.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 965 |
| Number Of Medicare Beneficiaries With Medical Services | 118 |
| Total Medical Submitted Charge Amount | 120840 |
| Total Medical Medicare Allowed Amount | 75466.1 |
| Total Medical Medicare Payment Amount | 58543.66 |
| Total Medical Medicare Standardized Payment Amount | 66196.09 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 45 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 53 |
| Number Of Male Beneficiaries | 65 |
| Number Of Non Hispanic White Beneficiaries | 88 |
| 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 | 38 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 38 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 64 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7336 |