National Provider Identifier [NPI]: |
1326167586 |
Last Name Of The Provider |
MULLANE |
First Name Of The Provider |
CHRISTEN |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2005 OXFORD AVE |
Street Address 2 Of The Provider |
APT B |
City Of The Provider |
AUSTIN |
Zip Code Of The Provider |
78704 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
296 |
Number Of Medicare Beneficiaries |
76 |
Total Submitted Charge Amount |
58765 |
Total Medicare Allowed Amount |
28964.87 |
Total Medicare Payment Amount |
22708.26 |
Total Medicare Standardized Payment Amount |
20078.15 |
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 |
8 |
Number Of Medical Services |
296 |
Number Of Medicare Beneficiaries With Medical Services |
76 |
Total Medical Submitted Charge Amount |
58765 |
Total Medical Medicare Allowed Amount |
28964.87 |
Total Medical Medicare Payment Amount |
22708.26 |
Total Medical Medicare Standardized Payment Amount |
20078.15 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
12 |
Number Of Beneficiaries Age 65 to 74 |
14 |
Number Of Beneficiaries Age 75 to 84 |
31 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
62 |
Number Of Male Beneficiaries |
14 |
Number Of Non Hispanic White Beneficiaries |
47 |
Number Of Black or African American Beneficiaries |
14 |
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 |
22 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
59 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
25 |
Percent Of With Stroke |
26 |
Average HCC Risk Score Of Beneficiaries |
2.3592 |