| National Provider Identifier [NPI]: | 1538113394 |
| Last Name Of The Provider | SCULLY |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 S ENOTA DR NE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 305013466 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 8496 |
| Number Of Medicare Beneficiaries | 2560 |
| Total Submitted Charge Amount | 1673894 |
| Total Medicare Allowed Amount | 529288.73 |
| Total Medicare Payment Amount | 393595.75 |
| Total Medicare Standardized Payment Amount | 415622.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 380 |
| Number Of Medicare Beneficiaries With Drug Services | 96 |
| Total Drug Submitted ChargeAmount | 50336 |
| Total Drug Medicare AllowedAmount | 20262.4 |
| Total Drug Medicare PaymentAmount | 15885.59 |
| Total Drug Medicare Standardized Payment Amount | 15885.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 8116 |
| Number Of Medicare Beneficiaries With Medical Services | 2560 |
| Total Medical Submitted Charge Amount | 1623558 |
| Total Medical Medicare Allowed Amount | 509026.33 |
| Total Medical Medicare Payment Amount | 377710.16 |
| Total Medical Medicare Standardized Payment Amount | 399736.48 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 280 |
| Number Of Beneficiaries Age 65 to 74 | 1016 |
| Number Of Beneficiaries Age 75 to 84 | 864 |
| Number Of Beneficiaries Age Greater 84 | 400 |
| Number Of Female Beneficiaries | 1332 |
| Number Of Male Beneficiaries | 1228 |
| Number Of Non Hispanic White Beneficiaries | 2397 |
| Number Of Black or African American Beneficiaries | 84 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2025 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 535 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6243 |