National Provider Identifier [NPI]: |
1790946861 |
Last Name Of The Provider |
MULLINS |
First Name Of The Provider |
D'ANNA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D., PH.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1320 WEST MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
43055 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
220 |
Number Of Medicare Beneficiaries |
105 |
Total Submitted Charge Amount |
18265 |
Total Medicare Allowed Amount |
13087.12 |
Total Medicare Payment Amount |
10066.58 |
Total Medicare Standardized Payment Amount |
10670.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
16 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
160 |
Total Drug Medicare AllowedAmount |
30.64 |
Total Drug Medicare PaymentAmount |
24.04 |
Total Drug Medicare Standardized Payment Amount |
24.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
204 |
Number Of Medicare Beneficiaries With Medical Services |
105 |
Total Medical Submitted Charge Amount |
18105 |
Total Medical Medicare Allowed Amount |
13056.48 |
Total Medical Medicare Payment Amount |
10042.54 |
Total Medical Medicare Standardized Payment Amount |
10646.67 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
37 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
67 |
Number Of Male Beneficiaries |
38 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
86 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
39 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6375 |