National Provider Identifier [NPI]: |
1912937947 |
Last Name Of The Provider |
CULEN |
First Name Of The Provider |
GREGORY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3807 SPRING ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
RACINE |
Zip Code Of The Provider |
534051667 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1656 |
Number Of Medicare Beneficiaries |
599 |
Total Submitted Charge Amount |
447701 |
Total Medicare Allowed Amount |
142809.68 |
Total Medicare Payment Amount |
110623.56 |
Total Medicare Standardized Payment Amount |
114383.48 |
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 |
21 |
Number Of Medical Services |
1656 |
Number Of Medicare Beneficiaries With Medical Services |
599 |
Total Medical Submitted Charge Amount |
447701 |
Total Medical Medicare Allowed Amount |
142809.68 |
Total Medical Medicare Payment Amount |
110623.56 |
Total Medical Medicare Standardized Payment Amount |
114383.48 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
134 |
Number Of Beneficiaries Age 65 to 74 |
166 |
Number Of Beneficiaries Age 75 to 84 |
158 |
Number Of Beneficiaries Age Greater 84 |
141 |
Number Of Female Beneficiaries |
338 |
Number Of Male Beneficiaries |
261 |
Number Of Non Hispanic White Beneficiaries |
514 |
Number Of Black or African American Beneficiaries |
47 |
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 |
380 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
219 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.9632 |