| National Provider Identifier [NPI]: | 1518962570 |
| Last Name Of The Provider | MCMULLIN |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1050 W 10TH ST |
| Street Address 2 Of The Provider | SUITE 450 |
| City Of The Provider | ROLLA |
| Zip Code Of The Provider | 654012905 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 3859 |
| Number Of Medicare Beneficiaries | 1581 |
| Total Submitted Charge Amount | 579505.3 |
| Total Medicare Allowed Amount | 153976.06 |
| Total Medicare Payment Amount | 111241.83 |
| Total Medicare Standardized Payment Amount | 120618.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 117 |
| Number Of Medicare Beneficiaries With Drug Services | 88 |
| Total Drug Submitted ChargeAmount | 3089 |
| Total Drug Medicare AllowedAmount | 1799.6 |
| Total Drug Medicare PaymentAmount | 1679.33 |
| Total Drug Medicare Standardized Payment Amount | 1679.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 3742 |
| Number Of Medicare Beneficiaries With Medical Services | 1581 |
| Total Medical Submitted Charge Amount | 576416.3 |
| Total Medical Medicare Allowed Amount | 152176.46 |
| Total Medical Medicare Payment Amount | 109562.5 |
| Total Medical Medicare Standardized Payment Amount | 118939.56 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 343 |
| Number Of Beneficiaries Age 65 to 74 | 498 |
| Number Of Beneficiaries Age 75 to 84 | 466 |
| Number Of Beneficiaries Age Greater 84 | 274 |
| Number Of Female Beneficiaries | 861 |
| Number Of Male Beneficiaries | 720 |
| Number Of Non Hispanic White Beneficiaries | 1531 |
| Number Of Black or African American Beneficiaries | 23 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1101 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 480 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7011 |