National Provider Identifier [NPI]: |
1740203389 |
Last Name Of The Provider |
MCMULLEN |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11375 CORTEZ BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BROOKSVILLE |
Zip Code Of The Provider |
346135409 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
2869 |
Number Of Medicare Beneficiaries |
820 |
Total Submitted Charge Amount |
419962.63 |
Total Medicare Allowed Amount |
87737.36 |
Total Medicare Payment Amount |
68550.01 |
Total Medicare Standardized Payment Amount |
60046.15 |
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 |
33 |
Number Of Medical Services |
2869 |
Number Of Medicare Beneficiaries With Medical Services |
820 |
Total Medical Submitted Charge Amount |
419962.63 |
Total Medical Medicare Allowed Amount |
87737.36 |
Total Medical Medicare Payment Amount |
68550.01 |
Total Medical Medicare Standardized Payment Amount |
60046.15 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
111 |
Number Of Beneficiaries Age 65 to 74 |
281 |
Number Of Beneficiaries Age 75 to 84 |
293 |
Number Of Beneficiaries Age Greater 84 |
135 |
Number Of Female Beneficiaries |
413 |
Number Of Male Beneficiaries |
407 |
Number Of Non Hispanic White Beneficiaries |
778 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
654 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
166 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
24 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
58 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9848 |