| National Provider Identifier [NPI]: | 1881785749 |
| Last Name Of The Provider | FULGHAM |
| First Name Of The Provider | SCOTT |
| 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 | 1100 RUBY TYLER PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUSCALOOSA |
| Zip Code Of The Provider | 354042959 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 15272 |
| Number Of Medicare Beneficiaries | 1550 |
| Total Submitted Charge Amount | 662453.5 |
| Total Medicare Allowed Amount | 466255.33 |
| Total Medicare Payment Amount | 373943.39 |
| Total Medicare Standardized Payment Amount | 394941.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 507 |
| Number Of Medicare Beneficiaries With Drug Services | 325 |
| Total Drug Submitted ChargeAmount | 14454 |
| Total Drug Medicare AllowedAmount | 9849.93 |
| Total Drug Medicare PaymentAmount | 9543.55 |
| Total Drug Medicare Standardized Payment Amount | 9543.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 14765 |
| Number Of Medicare Beneficiaries With Medical Services | 1550 |
| Total Medical Submitted Charge Amount | 647999.5 |
| Total Medical Medicare Allowed Amount | 456405.4 |
| Total Medical Medicare Payment Amount | 364399.84 |
| Total Medical Medicare Standardized Payment Amount | 385397.62 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 161 |
| Number Of Beneficiaries Age 65 to 74 | 574 |
| Number Of Beneficiaries Age 75 to 84 | 516 |
| Number Of Beneficiaries Age Greater 84 | 299 |
| Number Of Female Beneficiaries | 937 |
| Number Of Male Beneficiaries | 613 |
| Number Of Non Hispanic White Beneficiaries | 1375 |
| Number Of Black or African American Beneficiaries | 158 |
| 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 | 1359 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 191 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2574 |