| National Provider Identifier [NPI]: | 1992887087 |
| Last Name Of The Provider | SCANLON |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3400 SPRUCE ST |
| Street Address 2 Of The Provider | 1 SILVERSTEIN |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191044206 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 1665 |
| Number Of Medicare Beneficiaries | 1282 |
| Total Submitted Charge Amount | 177508 |
| Total Medicare Allowed Amount | 56130.4 |
| Total Medicare Payment Amount | 41236.97 |
| Total Medicare Standardized Payment Amount | 39698.74 |
| 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 | 78 |
| Number Of Medical Services | 1665 |
| Number Of Medicare Beneficiaries With Medical Services | 1282 |
| Total Medical Submitted Charge Amount | 177508 |
| Total Medical Medicare Allowed Amount | 56130.4 |
| Total Medical Medicare Payment Amount | 41236.97 |
| Total Medical Medicare Standardized Payment Amount | 39698.74 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 259 |
| Number Of Beneficiaries Age 65 to 74 | 536 |
| Number Of Beneficiaries Age 75 to 84 | 333 |
| Number Of Beneficiaries Age Greater 84 | 154 |
| Number Of Female Beneficiaries | 638 |
| Number Of Male Beneficiaries | 644 |
| Number Of Non Hispanic White Beneficiaries | 911 |
| Number Of Black or African American Beneficiaries | 307 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 986 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 296 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.185 |