| National Provider Identifier [NPI]: | 1215966577 |
| Last Name Of The Provider | CORNEAL |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1301 PLANTATION ISLAND DR S |
| Street Address 2 Of The Provider | SUITE 402A |
| City Of The Provider | ST AUGUSTINE |
| Zip Code Of The Provider | 320803108 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 2420 |
| Number Of Medicare Beneficiaries | 125 |
| Total Submitted Charge Amount | 552135.6 |
| Total Medicare Allowed Amount | 160931.31 |
| Total Medicare Payment Amount | 116678.23 |
| Total Medicare Standardized Payment Amount | 113161.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1109 |
| Number Of Medicare Beneficiaries With Drug Services | 88 |
| Total Drug Submitted ChargeAmount | 13238 |
| Total Drug Medicare AllowedAmount | 5735.12 |
| Total Drug Medicare PaymentAmount | 3990.39 |
| Total Drug Medicare Standardized Payment Amount | 3990.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1311 |
| Number Of Medicare Beneficiaries With Medical Services | 125 |
| Total Medical Submitted Charge Amount | 538897.6 |
| Total Medical Medicare Allowed Amount | 155196.19 |
| Total Medical Medicare Payment Amount | 112687.84 |
| Total Medical Medicare Standardized Payment Amount | 109171.23 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 41 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 74 |
| Number Of Male Beneficiaries | 51 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 101 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3068 |