| National Provider Identifier [NPI]: | 1821044595 |
| Last Name Of The Provider | JUSTESEN |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 377 N FAIRGROUNDS RD # 2 |
| Street Address 2 Of The Provider | |
| City Of The Provider | PRICE |
| Zip Code Of The Provider | 845014208 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 106 |
| Number Of Services | 3239.5 |
| Number Of Medicare Beneficiaries | 489 |
| Total Submitted Charge Amount | 842476 |
| Total Medicare Allowed Amount | 263467.72 |
| Total Medicare Payment Amount | 195308.23 |
| Total Medicare Standardized Payment Amount | 202638.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 824.5 |
| Number Of Medicare Beneficiaries With Drug Services | 251 |
| Total Drug Submitted ChargeAmount | 154222 |
| Total Drug Medicare AllowedAmount | 16446.55 |
| Total Drug Medicare PaymentAmount | 12860.27 |
| Total Drug Medicare Standardized Payment Amount | 12860.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 2415 |
| Number Of Medicare Beneficiaries With Medical Services | 489 |
| Total Medical Submitted Charge Amount | 688254 |
| Total Medical Medicare Allowed Amount | 247021.17 |
| Total Medical Medicare Payment Amount | 182447.96 |
| Total Medical Medicare Standardized Payment Amount | 189777.97 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 218 |
| Number Of Beneficiaries Age 75 to 84 | 133 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 288 |
| Number Of Male Beneficiaries | 201 |
| Number Of Non Hispanic White Beneficiaries | 452 |
| 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 | 404 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.988 |