| National Provider Identifier [NPI]: | 1174518310 |
| Last Name Of The Provider | CLULOW |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5601 21ST AVE W |
| Street Address 2 Of The Provider | #D |
| City Of The Provider | BRADENTON |
| Zip Code Of The Provider | 342095642 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 5470.5 |
| Number Of Medicare Beneficiaries | 785 |
| Total Submitted Charge Amount | 724739.34 |
| Total Medicare Allowed Amount | 366832.45 |
| Total Medicare Payment Amount | 280660.56 |
| Total Medicare Standardized Payment Amount | 283380.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 732.5 |
| Number Of Medicare Beneficiaries With Drug Services | 266 |
| Total Drug Submitted ChargeAmount | 15948.5 |
| Total Drug Medicare AllowedAmount | 7396.54 |
| Total Drug Medicare PaymentAmount | 7119.47 |
| Total Drug Medicare Standardized Payment Amount | 7119.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 4738 |
| Number Of Medicare Beneficiaries With Medical Services | 785 |
| Total Medical Submitted Charge Amount | 708790.84 |
| Total Medical Medicare Allowed Amount | 359435.91 |
| Total Medical Medicare Payment Amount | 273541.09 |
| Total Medical Medicare Standardized Payment Amount | 276261.31 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 278 |
| Number Of Beneficiaries Age 75 to 84 | 275 |
| Number Of Beneficiaries Age Greater 84 | 177 |
| Number Of Female Beneficiaries | 478 |
| Number Of Male Beneficiaries | 307 |
| Number Of Non Hispanic White Beneficiaries | 750 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 719 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 66 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3487 |