National Provider Identifier [NPI]: |
1376507384 |
Last Name Of The Provider |
MULLER |
First Name Of The Provider |
WAYNE |
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 |
7901 FROST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921232701 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
1816 |
Number Of Medicare Beneficiaries |
631 |
Total Submitted Charge Amount |
246183 |
Total Medicare Allowed Amount |
86089.09 |
Total Medicare Payment Amount |
67821.53 |
Total Medicare Standardized Payment Amount |
53790.26 |
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 |
34 |
Number Of Medical Services |
1816 |
Number Of Medicare Beneficiaries With Medical Services |
631 |
Total Medical Submitted Charge Amount |
246183 |
Total Medical Medicare Allowed Amount |
86089.09 |
Total Medical Medicare Payment Amount |
67821.53 |
Total Medical Medicare Standardized Payment Amount |
53790.26 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
89 |
Number Of Beneficiaries Age 65 to 74 |
275 |
Number Of Beneficiaries Age 75 to 84 |
205 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
371 |
Number Of Male Beneficiaries |
260 |
Number Of Non Hispanic White Beneficiaries |
405 |
Number Of Black or African American Beneficiaries |
35 |
Number Of AsianPacific Islander Beneficiaries |
74 |
Number Of Hispanic Beneficiaries |
102 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
440 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
191 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.729 |