National Provider Identifier [NPI]: |
1861835696 |
Last Name Of The Provider |
MULLES |
First Name Of The Provider |
MAYFLOR |
Middle Initial Of The Provider |
Q |
Credentials Of The Provider |
P.T. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3210 CLEVELAND AVE |
Street Address 2 Of The Provider |
STE 100 |
City Of The Provider |
FORT MYERS |
Zip Code Of The Provider |
339017182 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
2185 |
Number Of Medicare Beneficiaries |
107 |
Total Submitted Charge Amount |
166493 |
Total Medicare Allowed Amount |
61554.89 |
Total Medicare Payment Amount |
46881.2 |
Total Medicare Standardized Payment Amount |
29272.9 |
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 |
9 |
Number Of Medical Services |
2185 |
Number Of Medicare Beneficiaries With Medical Services |
107 |
Total Medical Submitted Charge Amount |
166493 |
Total Medical Medicare Allowed Amount |
61554.89 |
Total Medical Medicare Payment Amount |
46881.2 |
Total Medical Medicare Standardized Payment Amount |
29272.9 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
36 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
54 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
95 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
95 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9257 |