| National Provider Identifier [NPI]: | 1699777128 |
| Last Name Of The Provider | SCANLON |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1075 TOWN CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORANGE CITY |
| Zip Code Of The Provider | 327638360 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 4571 |
| Number Of Medicare Beneficiaries | 1162 |
| Total Submitted Charge Amount | 664647 |
| Total Medicare Allowed Amount | 513586.61 |
| Total Medicare Payment Amount | 396877.15 |
| Total Medicare Standardized Payment Amount | 397090.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 515 |
| Total Drug Medicare AllowedAmount | 175.42 |
| Total Drug Medicare PaymentAmount | 169.66 |
| Total Drug Medicare Standardized Payment Amount | 169.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 4556 |
| Number Of Medicare Beneficiaries With Medical Services | 1162 |
| Total Medical Submitted Charge Amount | 664132 |
| Total Medical Medicare Allowed Amount | 513411.19 |
| Total Medical Medicare Payment Amount | 396707.49 |
| Total Medical Medicare Standardized Payment Amount | 396921.33 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 167 |
| Number Of Beneficiaries Age 65 to 74 | 389 |
| Number Of Beneficiaries Age 75 to 84 | 363 |
| Number Of Beneficiaries Age Greater 84 | 243 |
| Number Of Female Beneficiaries | 619 |
| Number Of Male Beneficiaries | 543 |
| Number Of Non Hispanic White Beneficiaries | 929 |
| Number Of Black or African American Beneficiaries | 108 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 102 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 854 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 308 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 62 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.6175 |