National Provider Identifier [NPI]: |
1063588614 |
Last Name Of The Provider |
SCARBOROUGH |
First Name Of The Provider |
CAMEKA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4310 HARTLEY BRIDGE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MACON |
Zip Code Of The Provider |
31216 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
1941 |
Number Of Medicare Beneficiaries |
164 |
Total Submitted Charge Amount |
117342 |
Total Medicare Allowed Amount |
60929.54 |
Total Medicare Payment Amount |
42396.87 |
Total Medicare Standardized Payment Amount |
46577.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
330 |
Number Of Medicare Beneficiaries With Drug Services |
66 |
Total Drug Submitted ChargeAmount |
8513 |
Total Drug Medicare AllowedAmount |
2101.95 |
Total Drug Medicare PaymentAmount |
1973.98 |
Total Drug Medicare Standardized Payment Amount |
1973.98 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
1611 |
Number Of Medicare Beneficiaries With Medical Services |
164 |
Total Medical Submitted Charge Amount |
108829 |
Total Medical Medicare Allowed Amount |
58827.59 |
Total Medical Medicare Payment Amount |
40422.89 |
Total Medical Medicare Standardized Payment Amount |
44603.76 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
34 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
109 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
143 |
Number Of Black or African American Beneficiaries |
21 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
144 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8846 |