| National Provider Identifier [NPI]: | 1851354427 |
| Last Name Of The Provider | SCROGGINS |
| First Name Of The Provider | STACY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 E. OKLAHOMA |
| Street Address 2 Of The Provider | |
| City Of The Provider | MCALESTER |
| Zip Code Of The Provider | 74501 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 206 |
| Number Of Medicare Beneficiaries | 45 |
| Total Submitted Charge Amount | 6704.81 |
| Total Medicare Allowed Amount | 4811.95 |
| Total Medicare Payment Amount | 3372.09 |
| Total Medicare Standardized Payment Amount | 4282.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 84 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 656.78 |
| Total Drug Medicare AllowedAmount | 488.34 |
| Total Drug Medicare PaymentAmount | 442.7 |
| Total Drug Medicare Standardized Payment Amount | 442.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 122 |
| Number Of Medicare Beneficiaries With Medical Services | 44 |
| Total Medical Submitted Charge Amount | 6048.03 |
| Total Medical Medicare Allowed Amount | 4323.61 |
| Total Medical Medicare Payment Amount | 2929.39 |
| Total Medical Medicare Standardized Payment Amount | 3840.19 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 23 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 26 |
| Number Of Male Beneficiaries | 19 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 34 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8386 |