| National Provider Identifier [NPI]: | 1720084056 |
| Last Name Of The Provider | ULRICH |
| First Name Of The Provider | GUY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1265 36TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | VERO BEACH |
| Zip Code Of The Provider | 329606574 |
| 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 | 135 |
| Number Of Services | 12614 |
| Number Of Medicare Beneficiaries | 768 |
| Total Submitted Charge Amount | 569620.82 |
| Total Medicare Allowed Amount | 559810.17 |
| Total Medicare Payment Amount | 420983.7 |
| Total Medicare Standardized Payment Amount | 406774.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 4962 |
| Number Of Medicare Beneficiaries With Drug Services | 335 |
| Total Drug Submitted ChargeAmount | 85552.91 |
| Total Drug Medicare AllowedAmount | 84786.11 |
| Total Drug Medicare PaymentAmount | 70107.48 |
| Total Drug Medicare Standardized Payment Amount | 70107.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 122 |
| Number Of Medical Services | 7652 |
| Number Of Medicare Beneficiaries With Medical Services | 768 |
| Total Medical Submitted Charge Amount | 484067.91 |
| Total Medical Medicare Allowed Amount | 475024.06 |
| Total Medical Medicare Payment Amount | 350876.22 |
| Total Medical Medicare Standardized Payment Amount | 336666.95 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 290 |
| Number Of Beneficiaries Age 75 to 84 | 290 |
| Number Of Beneficiaries Age Greater 84 | 174 |
| Number Of Female Beneficiaries | 428 |
| Number Of Male Beneficiaries | 340 |
| Number Of Non Hispanic White Beneficiaries | 736 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9932 |