National Provider Identifier [NPI]: |
1295950111 |
Last Name Of The Provider |
VULLO |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
927 EAST BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHARLOTTE |
Zip Code Of The Provider |
282035203 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
104 |
Number Of Services |
677 |
Number Of Medicare Beneficiaries |
479 |
Total Submitted Charge Amount |
1274407 |
Total Medicare Allowed Amount |
88498.3 |
Total Medicare Payment Amount |
68387.54 |
Total Medicare Standardized Payment Amount |
72013.45 |
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 |
104 |
Number Of Medical Services |
677 |
Number Of Medicare Beneficiaries With Medical Services |
479 |
Total Medical Submitted Charge Amount |
1274407 |
Total Medical Medicare Allowed Amount |
88498.3 |
Total Medical Medicare Payment Amount |
68387.54 |
Total Medical Medicare Standardized Payment Amount |
72013.45 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
216 |
Number Of Beneficiaries Age 75 to 84 |
109 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
240 |
Number Of Male Beneficiaries |
239 |
Number Of Non Hispanic White Beneficiaries |
359 |
Number Of Black or African American Beneficiaries |
101 |
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 |
376 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
2.0123 |