National Provider Identifier [NPI]: |
1306870837 |
Last Name Of The Provider |
MULCAHY |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
675 N SAINT CLAIR ST |
Street Address 2 Of The Provider |
GALTER 21-100 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606115975 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Medical Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
133 |
Number Of Services |
108570 |
Number Of Medicare Beneficiaries |
637 |
Total Submitted Charge Amount |
9938448 |
Total Medicare Allowed Amount |
2408100.99 |
Total Medicare Payment Amount |
1871392.49 |
Total Medicare Standardized Payment Amount |
1852351.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
76 |
Number Of Drug Services |
102498 |
Number Of Medicare Beneficiaries With Drug Services |
413 |
Total Drug Submitted ChargeAmount |
8269095 |
Total Drug Medicare AllowedAmount |
2057634.96 |
Total Drug Medicare PaymentAmount |
1596854.58 |
Total Drug Medicare Standardized Payment Amount |
1596854.58 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
57 |
Number Of Medical Services |
6072 |
Number Of Medicare Beneficiaries With Medical Services |
634 |
Total Medical Submitted Charge Amount |
1669353 |
Total Medical Medicare Allowed Amount |
350466.03 |
Total Medical Medicare Payment Amount |
274537.91 |
Total Medical Medicare Standardized Payment Amount |
255497.39 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
322 |
Number Of Beneficiaries Age 75 to 84 |
175 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
306 |
Number Of Male Beneficiaries |
331 |
Number Of Non Hispanic White Beneficiaries |
435 |
Number Of Black or African American Beneficiaries |
114 |
Number Of AsianPacific Islander Beneficiaries |
31 |
Number Of Hispanic Beneficiaries |
43 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
14 |
Number Of Beneficiaries With Medicare Only Entitlement |
522 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
40 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
2.1594 |