| National Provider Identifier [NPI]: | 1689771636 |
| Last Name Of The Provider | SULLIVAN |
| First Name Of The Provider | ERIC |
| 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 | 920 COUNTRY CLUB RD |
| Street Address 2 Of The Provider | SUITE 200A |
| City Of The Provider | EUGENE |
| Zip Code Of The Provider | 974016024 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 2192 |
| Number Of Medicare Beneficiaries | 316 |
| Total Submitted Charge Amount | 234495 |
| Total Medicare Allowed Amount | 87598 |
| Total Medicare Payment Amount | 65438.47 |
| Total Medicare Standardized Payment Amount | 68020.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 144 |
| Number Of Medicare Beneficiaries With Drug Services | 108 |
| Total Drug Submitted ChargeAmount | 3634 |
| Total Drug Medicare AllowedAmount | 2507.65 |
| Total Drug Medicare PaymentAmount | 2332.79 |
| Total Drug Medicare Standardized Payment Amount | 2332.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 2048 |
| Number Of Medicare Beneficiaries With Medical Services | 316 |
| Total Medical Submitted Charge Amount | 230861 |
| Total Medical Medicare Allowed Amount | 85090.35 |
| Total Medical Medicare Payment Amount | 63105.68 |
| Total Medical Medicare Standardized Payment Amount | 65687.96 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 142 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 132 |
| Number Of Male Beneficiaries | 184 |
| Number Of Non Hispanic White Beneficiaries | 304 |
| Number Of Black or African American Beneficiaries | |
| 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 | 290 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0478 |