| National Provider Identifier [NPI]: | 1063645166 |
| Last Name Of The Provider | CULLEN |
| First Name Of The Provider | MICHELLE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | F.N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1109 N LAMAR BLVD |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | OXFORD |
| Zip Code Of The Provider | 386552861 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 1773 |
| Number Of Medicare Beneficiaries | 254 |
| Total Submitted Charge Amount | 77090.5 |
| Total Medicare Allowed Amount | 43102.28 |
| Total Medicare Payment Amount | 28088.32 |
| Total Medicare Standardized Payment Amount | 37046.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 645 |
| Number Of Medicare Beneficiaries With Drug Services | 125 |
| Total Drug Submitted ChargeAmount | 9577.5 |
| Total Drug Medicare AllowedAmount | 1075.51 |
| Total Drug Medicare PaymentAmount | 885.2 |
| Total Drug Medicare Standardized Payment Amount | 885.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 1128 |
| Number Of Medicare Beneficiaries With Medical Services | 254 |
| Total Medical Submitted Charge Amount | 67513 |
| Total Medical Medicare Allowed Amount | 42026.77 |
| Total Medical Medicare Payment Amount | 27203.12 |
| Total Medical Medicare Standardized Payment Amount | 36160.83 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 94 |
| Number Of Beneficiaries Age 65 to 74 | 103 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 150 |
| Number Of Male Beneficiaries | 104 |
| Number Of Non Hispanic White Beneficiaries | 167 |
| Number Of Black or African American Beneficiaries | 87 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 146 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 108 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9236 |