| National Provider Identifier [NPI]: | 1295788206 |
| Last Name Of The Provider | FULGHAM |
| First Name Of The Provider | PAT |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8230 WALNUT HILL LN |
| Street Address 2 Of The Provider | SUITE 700 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752314482 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 12540 |
| Number Of Medicare Beneficiaries | 1028 |
| Total Submitted Charge Amount | 853245 |
| Total Medicare Allowed Amount | 417750.27 |
| Total Medicare Payment Amount | 311873.84 |
| Total Medicare Standardized Payment Amount | 313849.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 5529 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 58995 |
| Total Drug Medicare AllowedAmount | 28009.66 |
| Total Drug Medicare PaymentAmount | 21178.84 |
| Total Drug Medicare Standardized Payment Amount | 21178.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 107 |
| Number Of Medical Services | 7011 |
| Number Of Medicare Beneficiaries With Medical Services | 1028 |
| Total Medical Submitted Charge Amount | 794250 |
| Total Medical Medicare Allowed Amount | 389740.61 |
| Total Medical Medicare Payment Amount | 290695 |
| Total Medical Medicare Standardized Payment Amount | 292670.68 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 465 |
| Number Of Beneficiaries Age 75 to 84 | 376 |
| Number Of Beneficiaries Age Greater 84 | 167 |
| Number Of Female Beneficiaries | 188 |
| Number Of Male Beneficiaries | 840 |
| Number Of Non Hispanic White Beneficiaries | 943 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1001 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0071 |