| National Provider Identifier [NPI]: | 1629218474 |
| Last Name Of The Provider | PULIDO |
| First Name Of The Provider | ALEX |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 700 ZEAGLER DR |
| Street Address 2 Of The Provider | STE 1 |
| City Of The Provider | PALATKA |
| Zip Code Of The Provider | 321776806 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 1534 |
| Number Of Medicare Beneficiaries | 215 |
| Total Submitted Charge Amount | 302020.7 |
| Total Medicare Allowed Amount | 141217.62 |
| Total Medicare Payment Amount | 104988.81 |
| Total Medicare Standardized Payment Amount | 107607.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 1244.7 |
| Total Drug Medicare AllowedAmount | 394.66 |
| Total Drug Medicare PaymentAmount | 381.02 |
| Total Drug Medicare Standardized Payment Amount | 381.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 1494 |
| Number Of Medicare Beneficiaries With Medical Services | 215 |
| Total Medical Submitted Charge Amount | 300776 |
| Total Medical Medicare Allowed Amount | 140822.96 |
| Total Medical Medicare Payment Amount | 104607.79 |
| Total Medical Medicare Standardized Payment Amount | 107226.19 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 95 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 131 |
| Number Of Male Beneficiaries | 84 |
| Number Of Non Hispanic White Beneficiaries | 194 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 153 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3267 |