| National Provider Identifier [NPI]: | 1891753240 |
| Last Name Of The Provider | MULLEN |
| First Name Of The Provider | DAVID |
| 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 | 49 LAKE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENWICH |
| Zip Code Of The Provider | 068304501 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 170 |
| Number Of Services | 4659 |
| Number Of Medicare Beneficiaries | 2820 |
| Total Submitted Charge Amount | 243216.36 |
| Total Medicare Allowed Amount | 226451.28 |
| Total Medicare Payment Amount | 176627.42 |
| Total Medicare Standardized Payment Amount | 168408.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 45.03 |
| Total Drug Medicare AllowedAmount | 42.45 |
| Total Drug Medicare PaymentAmount | 33.23 |
| Total Drug Medicare Standardized Payment Amount | 33.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 169 |
| Number Of Medical Services | 4619 |
| Number Of Medicare Beneficiaries With Medical Services | 2820 |
| Total Medical Submitted Charge Amount | 243171.33 |
| Total Medical Medicare Allowed Amount | 226408.83 |
| Total Medical Medicare Payment Amount | 176594.19 |
| Total Medical Medicare Standardized Payment Amount | 168375.22 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 153 |
| Number Of Beneficiaries Age 65 to 74 | 885 |
| Number Of Beneficiaries Age 75 to 84 | 965 |
| Number Of Beneficiaries Age Greater 84 | 817 |
| Number Of Female Beneficiaries | 1674 |
| Number Of Male Beneficiaries | 1146 |
| Number Of Non Hispanic White Beneficiaries | 2523 |
| Number Of Black or African American Beneficiaries | 86 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 107 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 56 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2381 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 439 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.475 |