National Provider Identifier [NPI]: |
1306886536 |
Last Name Of The Provider |
CULLY |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
ONE HOAG DRIVE |
Street Address 2 Of The Provider |
DEPARTMENT OF ANESTHESIOLOGY |
City Of The Provider |
NEWPORT BEACH |
Zip Code Of The Provider |
926634162 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
310 |
Number Of Medicare Beneficiaries |
280 |
Total Submitted Charge Amount |
397770 |
Total Medicare Allowed Amount |
79364.46 |
Total Medicare Payment Amount |
61970.56 |
Total Medicare Standardized Payment Amount |
59198.98 |
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 |
60 |
Number Of Medical Services |
310 |
Number Of Medicare Beneficiaries With Medical Services |
280 |
Total Medical Submitted Charge Amount |
397770 |
Total Medical Medicare Allowed Amount |
79364.46 |
Total Medical Medicare Payment Amount |
61970.56 |
Total Medical Medicare Standardized Payment Amount |
59198.98 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
42 |
Number Of Female Beneficiaries |
149 |
Number Of Male Beneficiaries |
131 |
Number Of Non Hispanic White Beneficiaries |
239 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
257 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4933 |