| National Provider Identifier [NPI]: | 1629019914 |
| Last Name Of The Provider | ECENBARGER |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5751 BYRON CENTER AVE SW |
| Street Address 2 Of The Provider | SUITE V |
| City Of The Provider | WYOMING |
| Zip Code Of The Provider | 495199621 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 603 |
| Number Of Medicare Beneficiaries | 413 |
| Total Submitted Charge Amount | 92384 |
| Total Medicare Allowed Amount | 66308.94 |
| Total Medicare Payment Amount | 49253.76 |
| Total Medicare Standardized Payment Amount | 51916.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 603 |
| Number Of Medicare Beneficiaries With Medical Services | 413 |
| Total Medical Submitted Charge Amount | 92384 |
| Total Medical Medicare Allowed Amount | 66308.94 |
| Total Medical Medicare Payment Amount | 49253.76 |
| Total Medical Medicare Standardized Payment Amount | 51916.83 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 76 |
| Number Of Beneficiaries Age 75 to 84 | 103 |
| Number Of Beneficiaries Age Greater 84 | 163 |
| Number Of Female Beneficiaries | 285 |
| Number Of Male Beneficiaries | 128 |
| Number Of Non Hispanic White Beneficiaries | 338 |
| Number Of Black or African American Beneficiaries | 63 |
| 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 | 46 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 367 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 66 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 24 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 29 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.5173 |