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Shanicka N. Scarbrough, MD

Family Practice · San Jose

NPI 1639307895

Medicare standing
Clear
Enrolled, allowed to bill and order, not excluded
Plans that list them
Not verified
Not the same as out of network.
Office
1

Offices

1 location · Skilled Facility Health Care Solutions Inc · 60 clinicians in this group

Looking this up.

Plan participation

Not verified

We could not verify current plan participation for this doctor. This does not mean they are out of network. Call Dr. Scarbrough’s office at (408) 295-2665 to ask if they take your plan before you enroll.

Checkups this office reported

Medicare did not publish checkup rates for this clinician.

Medicare’s overall office score
100.0 / 100
Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.

Original Medicare doctor bills

$328,798

Medicare paid this office $328,798 for 208 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Largest Original Medicare bills
Removal of muscle and/or tissue, 20.0 sq cm or less83$96,364$202
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes140$72,291$97
Removal of bone, 20.0 sq cm or less35$48,855$286
Subsequent nursing facility care with high level of medical decision making, per day at least 45 minutes54$33,495$139
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more114$23,115$69
See all 9 services
Every Original Medicare service billed
Removal of muscle and/or tissue, 20.0 sq cm or less83$96,364$202
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes140$72,291$97
Removal of bone, 20.0 sq cm or less35$48,855$286
Subsequent nursing facility care with high level of medical decision making, per day at least 45 minutes54$33,495$139
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more114$23,115$69
Initial nursing facility care with high level of medical decision making, per day 50 minutes or more103$16,632$160
Removal of skin and tissue, 20.0 sq cm or less77$15,325$106
Initial nursing facility care with moderate level of medical decision making, per day at least 35 minutes26$3,253$125
Removal of muscle and/or tissue, each additional 20.0 sq cm or less16$3,157$64

Procedures Medicare counted

Procedure volume Medicare published
Removal of skin lesions1-10None
Removal of tissue227More than 92% of doctors who do this

Who their Medicare patients are

208 Original Medicare patients in 2024. Average age 76 · Under 65 14% · 85 and older 21% · Women 47% · Also on Medicaid 73% · Health risk score 3.30. Sicker patients than 9 in 10 peers; the typical family practice clinician is at 1.13.

Conditions among them: High blood pressure 75% · Diabetes 56% · Depression 52% · Chronic kidney disease 48% · Heart failure 46% · Dementia 46% · Coronary heart disease 43% · COPD 40% · Atrial fibrillation 39% · Stroke 25% · Cancer 12%.

The office billed $484,695, Medicare allowed $410,664 and paid $328,798; for 2,463 services of 16 kinds.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Year by year

Original Medicare by year
20242082,463763.30$484,695$328,798
20233383,628762.99$630,730$414,203
20223923,178743.22$520,028$332,865
20212332,804733.35$517,619$318,176
20202752,750724.14$501,499$305,833
20192202,171713.74$339,150$203,233
201860291703.38$39,068$23,477
201631231722.37$35,930$15,694
201560502712.16$75,543$39,172
201448291732.11$55,115$28,266

Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.

See the services billed each year

2023: 11 services

Original Medicare services billed in 2023
Removal of muscle and/or tissue, 20.0 sq cm or less125$121,116$194
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes191$99,128$90
Removal of bone, 20.0 sq cm or less35$47,306$266
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more205$38,932$63
Initial nursing facility care with high level of medical decision making, per day 50 minutes or more215$32,862$152
Removal of skin and tissue, 20.0 sq cm or less122$28,569$101
Removal of muscle and/or tissue, each additional 20.0 sq cm or less29$18,483$63
Removal of bone, each additional 20.0 sq cm or less13$10,322$102
Application of chemical to stop tissue regrowth in wound29$8,198$76
Subsequent nursing facility care with high level of medical decision making, per day at least 45 minutes19$4,335$135
Removal of skin and tissue, each additional 20.0 sq cm or less15$1,631$36

2022: 12 services

Original Medicare services billed in 2022
Removal of muscle and/or tissue, 20.0 sq cm or less137$104,170$198
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes239$70,853$76
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more217$38,364$59
Initial nursing facility care with high level of medical decision making, per day 50 minutes or more191$27,011$141
Removal of bone, 20.0 sq cm or less44$25,972$271
Removal of skin and tissue, 20.0 sq cm or less126$24,983$100
Removal of muscle and/or tissue, each additional 20.0 sq cm or less35$15,561$62
Subsequent nursing facility care with high level of medical decision making, per day at least 45 minutes43$10,972$111
Initial nursing facility care with moderate level of medical decision making, per day at least 35 minutes53$5,061$95
Application of chemical to stop tissue regrowth in wound32$3,658$70
Removal of bone, each additional 20.0 sq cm or less12$3,271$102
Removal of skin and tissue, each additional 20.0 sq cm or less11$666$37

2021: 10 services

Original Medicare services billed in 2021
Removal of muscle and/or tissue, 20.0 sq cm or less97$99,417$192
Subsequent nursing facility care with high level of medical decision making, per day at least 45 minutes120$84,058$111
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes167$59,657$75
Removal of bone, 20.0 sq cm or less26$19,148$262
Initial nursing facility care with moderate level of medical decision making, per day at least 35 minutes92$9,568$104
Removal of muscle and/or tissue, each additional 20.0 sq cm or less25$9,516$61
Initial nursing facility care with high level of medical decision making, per day 50 minutes or more72$9,488$132
Removal of skin and tissue, 20.0 sq cm or less57$9,418$90
Application of chemical to stop tissue regrowth in wound26$7,222$75
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more18$2,102$57

2020: 13 services

Original Medicare services billed in 2020
Subsequent nursing facility care with high level of medical decision making, per day at least 45 minutes146$120,671$113
Removal of muscle and/or tissue, 20.0 sq cm or less134$90,160$191
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes105$25,950$76
Removal of bone, 20.0 sq cm or less20$12,051$262
Initial nursing facility care with high level of medical decision making, per day 50 minutes or more74$10,011$135
Removal of muscle and/or tissue, each additional 20.0 sq cm or less30$9,394$61
Subsequent nursing facility care with straightforward level of medical decision making, per day at least 10 minutes91$6,922$36
Removal of skin and tissue, 20.0 sq cm or less40$6,455$90
Application of chemical to stop tissue regrowth in wound31$5,634$69
Initial nursing facility care with moderate level of medical decision making, per day at least 35 minutes44$4,745$108
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more43$4,368$56
Initial nursing facility care with straightforward or low level of medical decision making, per day at least 25 minutes23$1,705$74
Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast15$884$55

2019: 12 services

Original Medicare services billed in 2019
Removal of muscle and/or tissue, 20.0 sq cm or less127$106,705$190
Subsequent nursing facility care with straightforward level of medical decision making, per day at least 10 minutes129$19,328$36
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more78$15,842$56
Removal of muscle and/or tissue, each additional 20.0 sq cm or less29$13,110$60
Application of chemical to stop tissue regrowth in wound29$11,256$67
Subsequent nursing facility care with moderate level of medical decision making, per day at least 30 minutes37$9,606$75
Removal of bone, 20.0 sq cm or less11$5,688$259
Initial nursing facility care with moderate level of medical decision making, per day at least 35 minutes46$4,892$106
Removal of skin and tissue, 20.0 sq cm or less25$4,060$90
Initial nursing facility care with straightforward or low level of medical decision making, per day at least 25 minutes55$3,969$72
Initial nursing facility care with high level of medical decision making, per day 50 minutes or more16$2,185$137
Biopsy of related skin growth, first growth15$1,214$76

2018: 5 services

Original Medicare services billed in 2018
Removal of muscle and/or tissue, 20.0 sq cm or less19$8,145$185
Subsequent nursing facility care with straightforward level of medical decision making, per day 20 minutes or more21$3,853$56
Subsequent nursing facility care with straightforward level of medical decision making, per day at least 10 minutes34$2,652$36
Removal of skin and tissue, 20.0 sq cm or less19$2,576$89
Initial nursing facility care with straightforward or low level of medical decision making, per day at least 25 minutes15$1,097$73

2016: 4 services

Original Medicare services billed in 2016
Residence visit for established patient with moderate level of medical decision making, per day at least 40 minutes28$6,724$77
Residence visit for established patient with high level of medical decision making, per day at least 60 minutes16$3,990$138
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month18$2,241$30
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a17$659$33

2015: 7 services

Original Medicare services billed in 2015
Residence visit for established patient with moderate level of medical decision making, per day at least 40 minutes46$17,025$97
Residence visit for established patient with high level of medical decision making, per day at least 60 minutes19$4,292$143
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month26$2,876$36
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a28$2,223$34
Transitional care management services for problem of high complexity12$2,165$180
Residence visit for established patient with low level of medical decision making, per day at least 30 minutes21$2,067$67
Influenza vaccine, trivalent, split virus, preservative-free, 0.5 ml dosage14$204$14

2014: 5 services

Original Medicare services billed in 2014
Residence visit for established patient with moderate level of medical decision making, per day at least 40 minutes39$15,091$105
Residence visit for new patient with high level of medical decision making, per day at least 75 minutes33$6,045$183
Residence visit for established patient with low level of medical decision making, per day at least 30 minutes15$1,591$66
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a19$1,235$34
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and22$1,022$44

Medicaid work

$29,644 in 2024

Medicaid paid $29,644 for 506 billed services this clinician did in 2024, up to 20 people in a month for one service.

Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.

Largest Medicaid services in 2024
Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less164$15,889
SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES211$6,700
SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES70$4,737
SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES61$2,317
Medicaid work by year
2024506420$29,644
20231,136624$39,071
2022764620$29,542
2021111116$3,444
2020382420$19,395
See the largest Medicaid services in earlier years

2023

Largest Medicaid services in 2023
Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less271$20,866
SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES440$9,301
SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES317$4,787
INITIAL NURSING FACILITY CARE HI MDM 50 MINUTES75$2,856
Short return visit12$660
Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less21$602

2022

Largest Medicaid services in 2022
Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less261$19,368
SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES226$3,691
SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES195$3,296
INITIAL NURSING FACILITY CARE HI MDM 50 MINUTES43$1,775
SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES23$902
Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less16$510

2021

Largest Medicaid services in 2021
SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES111$3,444

2020

Largest Medicaid services in 2020
Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less80$10,250
SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES195$6,651
SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES62$1,446
SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES45$1,048

Drugs they prescribed that Part D paid

$29,436

Pharmacies billed $29,436 in 2024.

This is pharmacy cost, not the office bill, and not what patients paid.

Opioids were 0% of their Part D prescriptions (0 of 411) in 2024. At or below the middle of the specialty; the typical family practice clinician is at 2%.

363 generic and 48 brand-name prescriptions · $29,436 in drug cost · 102 antibiotic prescriptions to 35 people.

Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.

Largest Part D drug costs
Santyl16$5,361$335
Ertapenem13$3,719$286
Gentamicin Sulfate49$2,844$58
Clobetasol Propionate11$1,114$101
Mupirocin47$779$17
See all 9 drugs
Every Part D drug this clinician prescribed
Santyl16$5,361$335
Ertapenem13$3,719$286
Gentamicin Sulfate49$2,844$58
Clobetasol Propionate11$1,114$101
Mupirocin47$779$17
Triamcinolone Acetonide36$371$10
Sulfamethoxazole-Trimethoprim25$238$10
Tobramycin Sulfate12$221$18
Silver Sulfadiazine17$171$10

Year by year

Part D prescribing by year
2024411820% (0)12%$29,436
2023336860% (0)None$37,187
2022470860% (0)None$37,397
2021508460% (0)14%$54,245
2020493690% (0)22%$48,668
201917229None12%$17,507
201846260% (0)None$2,176
201725063NoneNone$22,631
20161,391743% (47)20%$181,461
20151,628753% (56)15%$69,421
2014850784% (35)16%$35,680
2013904147None18%$36,047

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

See the drugs prescribed each year

2023: 7 drugs

Part D drugs prescribed in 2023
Santyl26$11,386$438
Gentamicin Sulfate65$4,894$75
Permethrin13$914$70
Mupirocin23$369$16
Terbinafine18$309$17
Triamcinolone Acetonide21$238$11
Sulfamethoxazole-Trimethoprim21$163$8

2022: 13 drugs

Part D drugs prescribed in 2022
Santyl30$8,817$294
Permethrin50$8,173$163
Gentamicin Sulfate79$5,044$64
Ertapenem26$4,708$181
Metronidazole15$1,720$115
Clindamycin Phosphate12$733$61
Mupirocin36$609$17
Ivermectin12$530$44
Ceftazidime14$490$35
Triamcinolone Acetonide28$334$12
Sulfamethoxazole-Trimethoprim22$264$12
Prednisone13$187$14
Ciprofloxacin15$174$12

2021: 12 drugs

Part D drugs prescribed in 2021
Ertapenem66$22,010$333
Santyl37$14,270$386
Gentamicin Sulfate122$6,585$54
Metronidazole16$1,904$119
Clindamycin Phosphate12$736$61
Mupirocin36$684$19
Sulfamethoxazole-Trimethoprim32$380$12
Amoxicillin-Clavulanate Potass11$336$31
Nyamyc12$314$26
Ciprofloxacin23$288$13
Triamcinolone Acetonide18$181$10
Levofloxacin14$168$12

2020: 12 drugs

Part D drugs prescribed in 2020
Santyl90$24,690$274
Ertapenem50$6,648$133
Gentamicin Sulfate87$6,423$74
Vancomycin31$2,772$89
Metronidazole17$2,442$144
Mupirocin47$859$18
Nystop16$547$34
Nyamyc21$388$18
Triamcinolone Acetonide22$227$10
Ciprofloxacin11$209$19
Silver Sulfadiazine11$172$16
Sulfamethoxazole-Trimethoprim12$115$10

2019: 7 drugs

Part D drugs prescribed in 2019
Santyl13$3,295$253
Ertapenem23$2,640$115
Gentamicin Sulfate17$1,336$79
Vancomycin13$604$46
Triamcinolone Acetonide26$291$11
Mupirocin17$250$15
Nystatin11$173$16

2017: 1 drug

Part D drugs prescribed in 2017
Atorvastatin12$127$11

2016: 51 drugs

Part D drugs prescribed in 2016
Lidocaine16$16,873$1,055
Novolog Flexpen12$11,647$971
Lantus Solostar15$11,023$735
Levemir Flextouch12$4,924$410
Symbicort17$4,763$280
Janumet11$4,208$383
Qvar11$2,129$194
Esomeprazole Magnesium15$1,660$111
Proair Hfa27$1,482$55
Ventolin Hfa19$1,419$75
Easy Comfort Pen Needles15$934$62
Fenofibrate31$784$25
Valsartan12$717$60
Atorvastatin53$582$11
Oxybutynin Chloride Er23$551$24
Metoprolol20$513$26
Duloxetine28$499$18
Risperidone17$479$28
Tamsulosin21$461$22
Hydrocodone-Acetaminophen17$436$26
Digoxin14$355$25
Glipizide Er13$309$24
Enalapril Maleate20$304$15
Montelukast28$208$7
Levothyroxine16$205$13
Simvastatin27$166$6
Polyethylene Glycol 335011$166$15
Glipizide24$162$7
Allopurinol14$160$11
Furosemide68$159$2
Carvedilol41$154$4
Lisinopril37$135$4
Donepezil25$128$5
Clopidogrel21$128$6
Metformin30$122$4
Diazepam11$116$11
Ibuprofen17$111$7
Atenolol12$104$9
Naproxen12$103$9
Finasteride16$98$6
Quetiapine15$91$6
Dicyclomine12$86$7
Omeprazole14$84$6
Amlodipine Besylate24$83$3
Alcohol Pads14$71$5
Gabapentin14$66$5
Tramadol14$64$5
Spironolactone12$63$5
Pantoprazole13$57$4
Hydrochlorothiazide24$55$2
Prednisone13$36$3

2015: 54 drugs

Part D drugs prescribed in 2015
Nasonex16$3,408$213
Symbicort11$2,743$249
Famotidine25$2,724$109
Proair Hfa34$1,761$52
Haloperidol16$1,332$83
Metoprolol24$693$29
Fenofibrate11$680$62
Oxybutynin Chloride Er23$668$29
Hydrocodone-Acetaminophen24$623$26
Fenofibrate29$621$21
Atorvastatin55$585$11
Duloxetine12$570$48
Tamsulosin24$525$22
Risperidone27$509$19
Enalapril Maleate19$467$25
Nifedipine Er20$433$22
Alcohol Pads13$314$24
Warfarin17$265$16
Montelukast29$250$9
Glipizide Er13$248$19
Metformin55$241$4
Amlodipine Besylate64$238$4
Baclofen11$233$21
Gabapentin18$218$12
Lisinopril54$213$4
Levothyroxine16$198$12
Potassium Chloride19$196$10
Furosemide51$194$4
Clopidogrel27$177$7
Simvastatin43$177$4
Naproxen28$176$6
Allopurinol20$172$9
Quetiapine20$162$8
Donepezil27$139$5
Diazepam12$137$11
Omeprazole23$136$6
Fluconazole14$125$9
Spironolactone18$120$7
Pantoprazole17$115$7
Tramadol25$108$4
Atenolol12$104$9
Hydrochlorothiazide37$98$3
Fluoxetine12$97$8
Glipizide13$96$7
Nizatidine12$93$8
Metoprolol15$80$5
Losartan17$79$5
Lorazepam13$70$5
Finasteride12$70$6
Azithromycin11$68$6
Carvedilol15$65$4
Paroxetine11$64$6
Ibuprofen11$56$5
Meloxicam12$31$3

2014: 25 drugs

Part D drugs prescribed in 2014
Proair Hfa24$1,205$50
Hydrocodone-Acetaminophen12$352$29
Risperidone19$325$17
Metformin38$286$8
Simvastatin39$271$7
Lisinopril48$262$5
Oxybutynin Chloride11$256$23
Fenofibrate14$239$17
Sucralfate11$204$19
Amlodipine Besylate29$203$7
Enalapril Maleate15$186$12
Hydralazine13$185$14
Atorvastatin13$184$14
Pantoprazole17$183$11
Omeprazole14$167$12
Montelukast12$148$12
Donepezil12$144$12
Tamsulosin11$128$12
Tramadol22$117$5
Allopurinol13$110$8
Hydrochlorothiazide16$109$7
Naproxen17$100$6
Losartan13$88$7
Metoprolol15$67$4
Furosemide16$61$4

2013: 24 drugs

Part D drugs prescribed in 2013
Diovan14$3,176$227
Nifedipine Er38$1,879$49
Qvar12$1,776$148
Proair Hfa21$1,009$48
Clopidogrel19$729$38
Amlodipine Besylate49$418$9
Potassium Chloride14$381$27
Atorvastatin15$374$25
Bd Ultra-Fine Pen Needle11$359$33
Metformin33$352$11
Hydrochlorothiazide61$327$5
Simvastatin28$285$10
Furosemide38$275$7
Enalapril Maleate20$236$12
Lisinopril35$212$6
Lisinopril-Hydrochlorothiazide26$202$8
Atenolol23$170$7
Omeprazole11$161$15
Warfarin17$159$9
Glipizide22$153$7
Lovastatin16$147$9
Levothyroxine13$120$9
Allopurinol11$97$9
Metoprolol15$65$4

Money from drug and device companies

$16 in 2022

Industry payments by year
202211None$16
202112None$26

Paid work is consulting, speaking, honoraria and royalties, as opposed to meals and travel.

A payment is not proof that care is biased.

Payments by company
Smith+NephewCollagenase Santyl$16
1 payment
  • Meals for Collagenase Santyl · 2022-01-18 · $16
See the published payment
Every published payment
Smith+NephewMeals · 2022-01-18Collagenase Santyl$16
See earlier years (2021)

2021: $26

Payments by company in 2021
Smith+NephewCollagenase Santyl$26
2 payments
  • Meals for Collagenase Santyl · 2021-08-31 · $14
  • Meals for Collagenase Santyl · 2021-06-22 · $12

Professional record

NPI
1639307895
Licence
IL 036.128645
Trained
University of Illinois College of Med (Chi/Peor/Rock/Chm-Urb), 2009
Gender
Female
More record details
Sole proprietor
No
Medicaid ID
IL 036128645
Taxonomy
General practice (208D00000X); Family medicine (207Q00000X)
Mailing address
Po Box 221788, Sacramento, CA, 95822
NPI first listed
2009-06-26
NPI last updated
2024-11-21
NPI record certified
2024-11-21

This is when the NPI record was last certified, not a medical board exam.