| National Provider Identifier [NPI]: | 1811975063 |
| Last Name Of The Provider | ULRICH |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5400 KELL BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WICHITA FALLS |
| Zip Code Of The Provider | 763101610 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 105334 |
| Number Of Medicare Beneficiaries | 435 |
| Total Submitted Charge Amount | 3349355 |
| Total Medicare Allowed Amount | 980181.55 |
| Total Medicare Payment Amount | 751268.71 |
| Total Medicare Standardized Payment Amount | 758834.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 58 |
| Number Of Drug Services | 98165 |
| Number Of Medicare Beneficiaries With Drug Services | 117 |
| Total Drug Submitted ChargeAmount | 2515504 |
| Total Drug Medicare AllowedAmount | 756467.02 |
| Total Drug Medicare PaymentAmount | 577185.04 |
| Total Drug Medicare Standardized Payment Amount | 577185.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 7169 |
| Number Of Medicare Beneficiaries With Medical Services | 435 |
| Total Medical Submitted Charge Amount | 833851 |
| Total Medical Medicare Allowed Amount | 223714.53 |
| Total Medical Medicare Payment Amount | 174083.67 |
| Total Medical Medicare Standardized Payment Amount | 181649.21 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 158 |
| Number Of Beneficiaries Age 75 to 84 | 165 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 216 |
| Number Of Male Beneficiaries | 219 |
| Number Of Non Hispanic White Beneficiaries | 369 |
| Number Of Black or African American Beneficiaries | 30 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 347 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 88 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 29 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.8885 |