| National Provider Identifier [NPI]: | 1396856019 |
| Last Name Of The Provider | MULLAN |
| First Name Of The Provider | JOAN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 211 E CHICAGO AVE |
| Street Address 2 Of The Provider | SUITE 1050 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606112637 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 1953 |
| Number Of Medicare Beneficiaries | 476 |
| Total Submitted Charge Amount | 305072 |
| Total Medicare Allowed Amount | 140551.74 |
| Total Medicare Payment Amount | 105018.9 |
| Total Medicare Standardized Payment Amount | 99641 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 136 |
| Number Of Medicare Beneficiaries With Drug Services | 96 |
| Total Drug Submitted ChargeAmount | 6993 |
| Total Drug Medicare AllowedAmount | 2930.06 |
| Total Drug Medicare PaymentAmount | 2846.53 |
| Total Drug Medicare Standardized Payment Amount | 2846.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 1817 |
| Number Of Medicare Beneficiaries With Medical Services | 476 |
| Total Medical Submitted Charge Amount | 298079 |
| Total Medical Medicare Allowed Amount | 137621.68 |
| Total Medical Medicare Payment Amount | 102172.37 |
| Total Medical Medicare Standardized Payment Amount | 96794.47 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 280 |
| Number Of Beneficiaries Age 75 to 84 | 133 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 420 |
| Number Of Male Beneficiaries | 56 |
| Number Of Non Hispanic White Beneficiaries | 436 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 5 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 8 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 32 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.7105 |