| National Provider Identifier [NPI]: | 1205908134 |
| Last Name Of The Provider | MULLEN |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 35 MILES ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DAMARISCOTTA |
| Zip Code Of The Provider | 045434047 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 142 |
| Number Of Services | 8134 |
| Number Of Medicare Beneficiaries | 3962 |
| Total Submitted Charge Amount | 967684 |
| Total Medicare Allowed Amount | 170540.11 |
| Total Medicare Payment Amount | 124995.08 |
| Total Medicare Standardized Payment Amount | 131898.33 |
| 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 | 142 |
| Number Of Medical Services | 8134 |
| Number Of Medicare Beneficiaries With Medical Services | 3962 |
| Total Medical Submitted Charge Amount | 967684 |
| Total Medical Medicare Allowed Amount | 170540.11 |
| Total Medical Medicare Payment Amount | 124995.08 |
| Total Medical Medicare Standardized Payment Amount | 131898.33 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 657 |
| Number Of Beneficiaries Age 65 to 74 | 1409 |
| Number Of Beneficiaries Age 75 to 84 | 1178 |
| Number Of Beneficiaries Age Greater 84 | 718 |
| Number Of Female Beneficiaries | 2519 |
| Number Of Male Beneficiaries | 1443 |
| Number Of Non Hispanic White Beneficiaries | 3849 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 57 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2638 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1324 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2699 |