| National Provider Identifier [NPI]: | 1841209368 |
| Last Name Of The Provider | SCULLY |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3841 PIPER STREET |
| Street Address 2 Of The Provider | SUITE T100 |
| City Of The Provider | ANCHORAGE |
| Zip Code Of The Provider | 99508 |
| State Code Of The Provider | AK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 4840 |
| Number Of Medicare Beneficiaries | 1261 |
| Total Submitted Charge Amount | 1791029 |
| Total Medicare Allowed Amount | 402562.67 |
| Total Medicare Payment Amount | 298859.96 |
| Total Medicare Standardized Payment Amount | 255805.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1237 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 11645 |
| Total Drug Medicare AllowedAmount | 6972.34 |
| Total Drug Medicare PaymentAmount | 5445.38 |
| Total Drug Medicare Standardized Payment Amount | 5445.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 3603 |
| Number Of Medicare Beneficiaries With Medical Services | 1261 |
| Total Medical Submitted Charge Amount | 1779384 |
| Total Medical Medicare Allowed Amount | 395590.33 |
| Total Medical Medicare Payment Amount | 293414.58 |
| Total Medical Medicare Standardized Payment Amount | 250360.49 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 128 |
| Number Of Beneficiaries Age 65 to 74 | 587 |
| Number Of Beneficiaries Age 75 to 84 | 402 |
| Number Of Beneficiaries Age Greater 84 | 144 |
| Number Of Female Beneficiaries | 606 |
| Number Of Male Beneficiaries | 655 |
| Number Of Non Hispanic White Beneficiaries | 1179 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 35 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 968 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 293 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.362 |