| National Provider Identifier [NPI]: | 1992753172 |
| Last Name Of The Provider | SCRIBNER |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 241 W WEAVER RD |
| Street Address 2 Of The Provider | #190 |
| City Of The Provider | FORSYTH |
| Zip Code Of The Provider | 625359799 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 1296 |
| Number Of Medicare Beneficiaries | 459 |
| Total Submitted Charge Amount | 142413.89 |
| Total Medicare Allowed Amount | 101684.72 |
| Total Medicare Payment Amount | 67552.69 |
| Total Medicare Standardized Payment Amount | 71049.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 124 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 2152.16 |
| Total Drug Medicare AllowedAmount | 1241.86 |
| Total Drug Medicare PaymentAmount | 1186.72 |
| Total Drug Medicare Standardized Payment Amount | 1186.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 1172 |
| Number Of Medicare Beneficiaries With Medical Services | 459 |
| Total Medical Submitted Charge Amount | 140261.73 |
| Total Medical Medicare Allowed Amount | 100442.86 |
| Total Medical Medicare Payment Amount | 66365.97 |
| Total Medical Medicare Standardized Payment Amount | 69863.07 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 222 |
| Number Of Beneficiaries Age 75 to 84 | 137 |
| Number Of Beneficiaries Age Greater 84 | 77 |
| Number Of Female Beneficiaries | 237 |
| Number Of Male Beneficiaries | 222 |
| Number Of Non Hispanic White Beneficiaries | 442 |
| 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 | 438 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9736 |