| National Provider Identifier [NPI]: | 1780996694 |
| Last Name Of The Provider | SCULL |
| First Name Of The Provider | HEATHER |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5210 WEBB RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336154518 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 1691 |
| Number Of Medicare Beneficiaries | 286 |
| Total Submitted Charge Amount | 221113 |
| Total Medicare Allowed Amount | 66126.33 |
| Total Medicare Payment Amount | 48708.35 |
| Total Medicare Standardized Payment Amount | 56879.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 1300 |
| Total Drug Medicare AllowedAmount | 46.51 |
| Total Drug Medicare PaymentAmount | 35.07 |
| Total Drug Medicare Standardized Payment Amount | 35.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 1665 |
| Number Of Medicare Beneficiaries With Medical Services | 286 |
| Total Medical Submitted Charge Amount | 219813 |
| Total Medical Medicare Allowed Amount | 66079.82 |
| Total Medical Medicare Payment Amount | 48673.28 |
| Total Medical Medicare Standardized Payment Amount | 56844.12 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 151 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 165 |
| Number Of Male Beneficiaries | 121 |
| Number Of Non Hispanic White Beneficiaries | 239 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 246 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0287 |