| National Provider Identifier [NPI]: | 1346200680 |
| Last Name Of The Provider | SCULLY |
| First Name Of The Provider | DENNIS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3822 SCHAPER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ERIE |
| Zip Code Of The Provider | 165083360 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 1581 |
| Number Of Medicare Beneficiaries | 399 |
| Total Submitted Charge Amount | 148241.5 |
| Total Medicare Allowed Amount | 115685.38 |
| Total Medicare Payment Amount | 81222.21 |
| Total Medicare Standardized Payment Amount | 85220.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 235 |
| Number Of Medicare Beneficiaries With Drug Services | 130 |
| Total Drug Submitted ChargeAmount | 8600.5 |
| Total Drug Medicare AllowedAmount | 5543.81 |
| Total Drug Medicare PaymentAmount | 5389.31 |
| Total Drug Medicare Standardized Payment Amount | 5389.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1346 |
| Number Of Medicare Beneficiaries With Medical Services | 399 |
| Total Medical Submitted Charge Amount | 139641 |
| Total Medical Medicare Allowed Amount | 110141.57 |
| Total Medical Medicare Payment Amount | 75832.9 |
| Total Medical Medicare Standardized Payment Amount | 79830.83 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 193 |
| Number Of Beneficiaries Age 75 to 84 | 97 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 241 |
| Number Of Male Beneficiaries | 158 |
| Number Of Non Hispanic White Beneficiaries | 388 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 366 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0787 |