| National Provider Identifier [NPI]: | 1629285523 | 
| Last Name Of The Provider | SCOTT | 
| First Name Of The Provider | ALEXANDRA | 
| Middle Initial Of The Provider | L | 
| Credentials Of The Provider | PA | 
| Gender Of The Provider | F | 
| Entity Type Of The Provider | I | 
| Street Address 1 Of The Provider | 1500 E MEDICAL CENTER DR | 
| Street Address 2 Of The Provider | B1 FLOOR TAUMBAN CENTER RECP MOS | 
| City Of The Provider | ANN ARBOR | 
| Zip Code Of The Provider | 481095317 | 
| State Code Of The Provider | MI | 
| Country Code Of The Provider | US | 
| Provider Type Of The Provider | Physician Assistant | 
| Medicare Participation Indicator | Y | 
| Number Of HCPCS | 7 | 
| Number Of Services | 28 | 
| Number Of Medicare Beneficiaries | 26 | 
| Total Submitted Charge Amount | 6746 | 
| Total Medicare Allowed Amount | 2934.42 | 
| Total Medicare Payment Amount | 2300.67 | 
| Total Medicare Standardized Payment Amount | 2600.8 | 
| 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 | 7 | 
| Number Of Medical Services | 28 | 
| Number Of Medicare Beneficiaries With Medical Services | 26 | 
| Total Medical Submitted Charge Amount | 6746 | 
| Total Medical Medicare Allowed Amount | 2934.42 | 
| Total Medical Medicare Payment Amount | 2300.67 | 
| Total Medical Medicare Standardized Payment Amount | 2600.8 | 
| Average Age Of Beneficiaries | 67 | 
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 14 | 
| Number Of Male Beneficiaries | 12 | 
| 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 | 14 | 
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 | 
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 58 | 
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 46 | 
| Percent Of With Diabetes | 42 | 
| Percent Of With Hyperlipidemia | 54 | 
| Percent Of With Hypertension | 75 | 
| Percent Of With Ischemic Heart Disease | 54 | 
| Percent Of With Osteoporosis | 0 | 
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 | 
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 3.2661 |