| National Provider Identifier [NPI]: | 1295809192 |
| Last Name Of The Provider | MCCULLOUGH |
| First Name Of The Provider | FINNIAN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | ARNP, MS, BC |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 LIMIT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEAVENWORTH |
| Zip Code Of The Provider | 660484435 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 566 |
| Number Of Medicare Beneficiaries | 215 |
| Total Submitted Charge Amount | 42847.5 |
| Total Medicare Allowed Amount | 20607.46 |
| Total Medicare Payment Amount | 12875.09 |
| Total Medicare Standardized Payment Amount | 16594.81 |
| 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 | 10 |
| Number Of Medical Services | 566 |
| Number Of Medicare Beneficiaries With Medical Services | 215 |
| Total Medical Submitted Charge Amount | 42847.5 |
| Total Medical Medicare Allowed Amount | 20607.46 |
| Total Medical Medicare Payment Amount | 12875.09 |
| Total Medical Medicare Standardized Payment Amount | 16594.81 |
| Average Age Of Beneficiaries | 51 |
| Number Of Beneficiaries Age Less65 | 186 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 138 |
| Number Of Male Beneficiaries | 77 |
| Number Of Non Hispanic White Beneficiaries | 171 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 59 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 156 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 66 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 41 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1328 |