| National Provider Identifier [NPI]: | 1093030918 |
| Last Name Of The Provider | FULMER |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 110 N BROADVIEW ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENBRIER |
| Zip Code Of The Provider | 720589475 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 937 |
| Number Of Medicare Beneficiaries | 344 |
| Total Submitted Charge Amount | 47898.05 |
| Total Medicare Allowed Amount | 23295.39 |
| Total Medicare Payment Amount | 16803.11 |
| Total Medicare Standardized Payment Amount | 18796.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 291 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 1657.5 |
| Total Drug Medicare AllowedAmount | 212.66 |
| Total Drug Medicare PaymentAmount | 163.62 |
| Total Drug Medicare Standardized Payment Amount | 163.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 646 |
| Number Of Medicare Beneficiaries With Medical Services | 338 |
| Total Medical Submitted Charge Amount | 46240.55 |
| Total Medical Medicare Allowed Amount | 23082.73 |
| Total Medical Medicare Payment Amount | 16639.49 |
| Total Medical Medicare Standardized Payment Amount | 18632.7 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 133 |
| Number Of Beneficiaries Age 75 to 84 | 75 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 218 |
| Number Of Male Beneficiaries | 126 |
| Number Of Non Hispanic White Beneficiaries | 317 |
| 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 | 248 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.979 |