National Provider Identifier [NPI]: |
1396784377 |
Last Name Of The Provider |
MULLINS |
First Name Of The Provider |
J |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3800 S NATIONAL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658075209 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
144 |
Number Of Services |
1585 |
Number Of Medicare Beneficiaries |
626 |
Total Submitted Charge Amount |
556002.1 |
Total Medicare Allowed Amount |
233453.6 |
Total Medicare Payment Amount |
179829.01 |
Total Medicare Standardized Payment Amount |
188842.26 |
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 |
144 |
Number Of Medical Services |
1585 |
Number Of Medicare Beneficiaries With Medical Services |
626 |
Total Medical Submitted Charge Amount |
556002.1 |
Total Medical Medicare Allowed Amount |
233453.6 |
Total Medical Medicare Payment Amount |
179829.01 |
Total Medical Medicare Standardized Payment Amount |
188842.26 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
266 |
Number Of Beneficiaries Age 75 to 84 |
220 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
249 |
Number Of Male Beneficiaries |
377 |
Number Of Non Hispanic White Beneficiaries |
611 |
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 |
530 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
96 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.5477 |