| National Provider Identifier [NPI]: | 1093708901 |
| Last Name Of The Provider | CULLINANE |
| First Name Of The Provider | STEPHANIE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | PA C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 535 MILLER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILL VALLEY |
| Zip Code Of The Provider | 949412905 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 2193 |
| Number Of Medicare Beneficiaries | 396 |
| Total Submitted Charge Amount | 188130 |
| Total Medicare Allowed Amount | 118353.6 |
| Total Medicare Payment Amount | 85041.84 |
| Total Medicare Standardized Payment Amount | 82896.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 13 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 3445 |
| Total Drug Medicare AllowedAmount | 3231.5 |
| Total Drug Medicare PaymentAmount | 2533.44 |
| Total Drug Medicare Standardized Payment Amount | 2533.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 2180 |
| Number Of Medicare Beneficiaries With Medical Services | 396 |
| Total Medical Submitted Charge Amount | 184685 |
| Total Medical Medicare Allowed Amount | 115122.1 |
| Total Medical Medicare Payment Amount | 82508.4 |
| Total Medical Medicare Standardized Payment Amount | 80362.99 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 247 |
| Number Of Beneficiaries Age 75 to 84 | 103 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 211 |
| Number Of Male Beneficiaries | 185 |
| Number Of Non Hispanic White Beneficiaries | 377 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 10 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 39 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.6904 |