National Provider Identifier [NPI]: |
1013982636 |
Last Name Of The Provider |
MULLEN |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1221 MADISON |
Street Address 2 Of The Provider |
SUITE 1210 |
City Of The Provider |
SEATTLE |
Zip Code Of The Provider |
981041370 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
114 |
Number Of Services |
5282 |
Number Of Medicare Beneficiaries |
378 |
Total Submitted Charge Amount |
627438 |
Total Medicare Allowed Amount |
257496.87 |
Total Medicare Payment Amount |
190555.98 |
Total Medicare Standardized Payment Amount |
186951.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
3231 |
Number Of Medicare Beneficiaries With Drug Services |
66 |
Total Drug Submitted ChargeAmount |
119568 |
Total Drug Medicare AllowedAmount |
50045.35 |
Total Drug Medicare PaymentAmount |
38177.61 |
Total Drug Medicare Standardized Payment Amount |
38177.61 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
106 |
Number Of Medical Services |
2051 |
Number Of Medicare Beneficiaries With Medical Services |
378 |
Total Medical Submitted Charge Amount |
507870 |
Total Medical Medicare Allowed Amount |
207451.52 |
Total Medical Medicare Payment Amount |
152378.37 |
Total Medical Medicare Standardized Payment Amount |
148773.81 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
175 |
Number Of Beneficiaries Age 75 to 84 |
129 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
56 |
Number Of Male Beneficiaries |
322 |
Number Of Non Hispanic White Beneficiaries |
314 |
Number Of Black or African American Beneficiaries |
22 |
Number Of AsianPacific Islander Beneficiaries |
19 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
349 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
33 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2406 |