| National Provider Identifier [NPI]: | 1386642718 |
| Last Name Of The Provider | FULD |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 25 CROSSROADS DR |
| Street Address 2 Of The Provider | SUITE 205 |
| City Of The Provider | OWINGS MILLS |
| Zip Code Of The Provider | 211175421 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 49318 |
| Number Of Medicare Beneficiaries | 1077 |
| Total Submitted Charge Amount | 7363537.18 |
| Total Medicare Allowed Amount | 2016414.12 |
| Total Medicare Payment Amount | 1553189.22 |
| Total Medicare Standardized Payment Amount | 1470826.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 45013 |
| Number Of Medicare Beneficiaries With Drug Services | 594 |
| Total Drug Submitted ChargeAmount | 95770.23 |
| Total Drug Medicare AllowedAmount | 37260.36 |
| Total Drug Medicare PaymentAmount | 28549.82 |
| Total Drug Medicare Standardized Payment Amount | 28549.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 4305 |
| Number Of Medicare Beneficiaries With Medical Services | 1077 |
| Total Medical Submitted Charge Amount | 7267766.95 |
| Total Medical Medicare Allowed Amount | 1979153.76 |
| Total Medical Medicare Payment Amount | 1524639.4 |
| Total Medical Medicare Standardized Payment Amount | 1442276.85 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 359 |
| Number Of Beneficiaries Age 65 to 74 | 312 |
| Number Of Beneficiaries Age 75 to 84 | 291 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 505 |
| Number Of Male Beneficiaries | 572 |
| Number Of Non Hispanic White Beneficiaries | 341 |
| Number Of Black or African American Beneficiaries | 702 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 716 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 361 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 59 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 70 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 6.3604 |