| National Provider Identifier [NPI]: | 1275587586 |
| Last Name Of The Provider | BLEDSOE |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2400 BALFOUR RD |
| Street Address 2 Of The Provider | SUITE 120 |
| City Of The Provider | BRENTWOOD |
| Zip Code Of The Provider | 945134945 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 1612 |
| Number Of Medicare Beneficiaries | 321 |
| Total Submitted Charge Amount | 203995 |
| Total Medicare Allowed Amount | 108983.67 |
| Total Medicare Payment Amount | 75156.82 |
| Total Medicare Standardized Payment Amount | 66659.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 436 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 14010 |
| Total Drug Medicare AllowedAmount | 5721.52 |
| Total Drug Medicare PaymentAmount | 5123.84 |
| Total Drug Medicare Standardized Payment Amount | 5123.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 1176 |
| Number Of Medicare Beneficiaries With Medical Services | 321 |
| Total Medical Submitted Charge Amount | 189985 |
| Total Medical Medicare Allowed Amount | 103262.15 |
| Total Medical Medicare Payment Amount | 70032.98 |
| Total Medical Medicare Standardized Payment Amount | 61535.35 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 87 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 154 |
| Number Of Male Beneficiaries | 167 |
| Number Of Non Hispanic White Beneficiaries | 242 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 280 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0559 |