| National Provider Identifier [NPI]: | 1407850126 |
| Last Name Of The Provider | ULRICH |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 MEMORIAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | PIEDMONT |
| Zip Code Of The Provider | 362726631 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 11947 |
| Number Of Medicare Beneficiaries | 1276 |
| Total Submitted Charge Amount | 507929.3 |
| Total Medicare Allowed Amount | 458508.79 |
| Total Medicare Payment Amount | 355919.52 |
| Total Medicare Standardized Payment Amount | 386431.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 3493 |
| Number Of Medicare Beneficiaries With Drug Services | 456 |
| Total Drug Submitted ChargeAmount | 32247 |
| Total Drug Medicare AllowedAmount | 9217.41 |
| Total Drug Medicare PaymentAmount | 8121.57 |
| Total Drug Medicare Standardized Payment Amount | 8121.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 8454 |
| Number Of Medicare Beneficiaries With Medical Services | 1276 |
| Total Medical Submitted Charge Amount | 475682.3 |
| Total Medical Medicare Allowed Amount | 449291.38 |
| Total Medical Medicare Payment Amount | 347797.95 |
| Total Medical Medicare Standardized Payment Amount | 378310.37 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 384 |
| Number Of Beneficiaries Age 65 to 74 | 393 |
| Number Of Beneficiaries Age 75 to 84 | 304 |
| Number Of Beneficiaries Age Greater 84 | 195 |
| Number Of Female Beneficiaries | 765 |
| Number Of Male Beneficiaries | 511 |
| Number Of Non Hispanic White Beneficiaries | 1171 |
| Number Of Black or African American Beneficiaries | 93 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 817 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 459 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2898 |