National Provider Identifier [NPI]: |
1003881608 |
Last Name Of The Provider |
SCROGGINS |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8288 S BROADWAY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TYLER |
Zip Code Of The Provider |
757035262 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
2160 |
Number Of Medicare Beneficiaries |
586 |
Total Submitted Charge Amount |
348194 |
Total Medicare Allowed Amount |
145135.41 |
Total Medicare Payment Amount |
105781.89 |
Total Medicare Standardized Payment Amount |
112534.52 |
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 |
36 |
Number Of Medical Services |
2160 |
Number Of Medicare Beneficiaries With Medical Services |
586 |
Total Medical Submitted Charge Amount |
348194 |
Total Medical Medicare Allowed Amount |
145135.41 |
Total Medical Medicare Payment Amount |
105781.89 |
Total Medical Medicare Standardized Payment Amount |
112534.52 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
259 |
Number Of Beneficiaries Age 75 to 84 |
205 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
328 |
Number Of Male Beneficiaries |
258 |
Number Of Non Hispanic White Beneficiaries |
557 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
573 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
0.9444 |