National Provider Identifier [NPI]: |
1114978228 |
Last Name Of The Provider |
HULL |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4940 EASTERN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
212242735 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
352 |
Number Of Medicare Beneficiaries |
314 |
Total Submitted Charge Amount |
86955 |
Total Medicare Allowed Amount |
29230.61 |
Total Medicare Payment Amount |
21879.95 |
Total Medicare Standardized Payment Amount |
20836.24 |
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 |
13 |
Number Of Medical Services |
352 |
Number Of Medicare Beneficiaries With Medical Services |
314 |
Total Medical Submitted Charge Amount |
86955 |
Total Medical Medicare Allowed Amount |
29230.61 |
Total Medical Medicare Payment Amount |
21879.95 |
Total Medical Medicare Standardized Payment Amount |
20836.24 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
186 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
168 |
Number Of Male Beneficiaries |
146 |
Number Of Non Hispanic White Beneficiaries |
225 |
Number Of Black or African American Beneficiaries |
73 |
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 |
129 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
185 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5006 |