| National Provider Identifier [NPI]: | 1053364844 |
| Last Name Of The Provider | FULMER |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3500 GASTON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 75246 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 161 |
| Number Of Services | 7145 |
| Number Of Medicare Beneficiaries | 4320 |
| Total Submitted Charge Amount | 758604.51 |
| Total Medicare Allowed Amount | 184241.37 |
| Total Medicare Payment Amount | 143126.24 |
| Total Medicare Standardized Payment Amount | 146161.58 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 895 |
| Number Of Beneficiaries Age 65 to 74 | 1727 |
| Number Of Beneficiaries Age 75 to 84 | 1179 |
| Number Of Beneficiaries Age Greater 84 | 519 |
| Number Of Female Beneficiaries | 2667 |
| Number Of Male Beneficiaries | 1653 |
| Number Of Non Hispanic White Beneficiaries | 2935 |
| Number Of Black or African American Beneficiaries | 939 |
| Number Of AsianPacific Islander Beneficiaries | 38 |
| Number Of Hispanic Beneficiaries | 366 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3180 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1140 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9477 |