| National Provider Identifier [NPI]: | 1427150788 |
| Last Name Of The Provider | BULSON |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8455 66TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PINELLAS PARK |
| Zip Code Of The Provider | 337811206 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 47826 |
| Number Of Medicare Beneficiaries | 2800 |
| Total Submitted Charge Amount | 9141460 |
| Total Medicare Allowed Amount | 2525141.84 |
| Total Medicare Payment Amount | 1964545.05 |
| Total Medicare Standardized Payment Amount | 1794065.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 47826 |
| Number Of Medicare Beneficiaries With Medical Services | 2800 |
| Total Medical Submitted Charge Amount | 9141460 |
| Total Medical Medicare Allowed Amount | 2525141.84 |
| Total Medical Medicare Payment Amount | 1964545.05 |
| Total Medical Medicare Standardized Payment Amount | 1794065.94 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 888 |
| Number Of Beneficiaries Age 75 to 84 | 1173 |
| Number Of Beneficiaries Age Greater 84 | 651 |
| Number Of Female Beneficiaries | 1046 |
| Number Of Male Beneficiaries | 1754 |
| Number Of Non Hispanic White Beneficiaries | 2735 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2698 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2816 |