National Provider Identifier [NPI]: |
1437337219 |
Last Name Of The Provider |
CULLEN |
First Name Of The Provider |
KATHRYN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
99 BEAUVOIR AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SUMMIT |
Zip Code Of The Provider |
079013533 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
1296 |
Number Of Medicare Beneficiaries |
478 |
Total Submitted Charge Amount |
291225 |
Total Medicare Allowed Amount |
128785.55 |
Total Medicare Payment Amount |
100096.51 |
Total Medicare Standardized Payment Amount |
93742.17 |
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 |
16 |
Number Of Medical Services |
1296 |
Number Of Medicare Beneficiaries With Medical Services |
478 |
Total Medical Submitted Charge Amount |
291225 |
Total Medical Medicare Allowed Amount |
128785.55 |
Total Medical Medicare Payment Amount |
100096.51 |
Total Medical Medicare Standardized Payment Amount |
93742.17 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
134 |
Number Of Beneficiaries Age 75 to 84 |
150 |
Number Of Beneficiaries Age Greater 84 |
135 |
Number Of Female Beneficiaries |
294 |
Number Of Male Beneficiaries |
184 |
Number Of Non Hispanic White Beneficiaries |
382 |
Number Of Black or African American Beneficiaries |
52 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
368 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
110 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.4476 |