| National Provider Identifier [NPI]: | 1699726505 |
| Last Name Of The Provider | SCURLOCK |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 110 S 17TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST CHARLES |
| Zip Code Of The Provider | 601742526 |
| 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 | 52 |
| Number Of Services | 1149.5 |
| Number Of Medicare Beneficiaries | 257 |
| Total Submitted Charge Amount | 99134 |
| Total Medicare Allowed Amount | 73197.29 |
| Total Medicare Payment Amount | 54298.67 |
| Total Medicare Standardized Payment Amount | 52399.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 190.5 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 6528 |
| Total Drug Medicare AllowedAmount | 5129.07 |
| Total Drug Medicare PaymentAmount | 4734.35 |
| Total Drug Medicare Standardized Payment Amount | 4734.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 959 |
| Number Of Medicare Beneficiaries With Medical Services | 257 |
| Total Medical Submitted Charge Amount | 92606 |
| Total Medical Medicare Allowed Amount | 68068.22 |
| Total Medical Medicare Payment Amount | 49564.32 |
| Total Medical Medicare Standardized Payment Amount | 47665.12 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 163 |
| Number Of Beneficiaries Age 75 to 84 | 63 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 107 |
| Number Of Male Beneficiaries | 150 |
| Number Of Non Hispanic White Beneficiaries | 244 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 246 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8237 |