National Provider Identifier [NPI]: |
1942206578 |
Last Name Of The Provider |
MULLENIX |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
581 E GOLF RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DES PLAINES |
Zip Code Of The Provider |
600162349 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
980 |
Number Of Medicare Beneficiaries |
638 |
Total Submitted Charge Amount |
149977.58 |
Total Medicare Allowed Amount |
115233.77 |
Total Medicare Payment Amount |
74899.89 |
Total Medicare Standardized Payment Amount |
70117.03 |
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 |
980 |
Number Of Medicare Beneficiaries With Medical Services |
638 |
Total Medical Submitted Charge Amount |
149977.58 |
Total Medical Medicare Allowed Amount |
115233.77 |
Total Medical Medicare Payment Amount |
74899.89 |
Total Medical Medicare Standardized Payment Amount |
70117.03 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
227 |
Number Of Beneficiaries Age 75 to 84 |
276 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
363 |
Number Of Male Beneficiaries |
275 |
Number Of Non Hispanic White Beneficiaries |
602 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
21 |
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 |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
6 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9211 |