| National Provider Identifier [NPI]: | 1063413581 |
| Last Name Of The Provider | ULRICH |
| First Name Of The Provider | DENNIS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1655 E HIGHWAY 3094 |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAST BERNSTADT |
| Zip Code Of The Provider | 407296216 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 8242 |
| Number Of Medicare Beneficiaries | 593 |
| Total Submitted Charge Amount | 432465 |
| Total Medicare Allowed Amount | 271598.43 |
| Total Medicare Payment Amount | 186246.88 |
| Total Medicare Standardized Payment Amount | 203362.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 2494 |
| Number Of Medicare Beneficiaries With Drug Services | 412 |
| Total Drug Submitted ChargeAmount | 47029 |
| Total Drug Medicare AllowedAmount | 4670.84 |
| Total Drug Medicare PaymentAmount | 3440.46 |
| Total Drug Medicare Standardized Payment Amount | 3440.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 5748 |
| Number Of Medicare Beneficiaries With Medical Services | 593 |
| Total Medical Submitted Charge Amount | 385436 |
| Total Medical Medicare Allowed Amount | 266927.59 |
| Total Medical Medicare Payment Amount | 182806.42 |
| Total Medical Medicare Standardized Payment Amount | 199922.12 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 181 |
| Number Of Beneficiaries Age 65 to 74 | 236 |
| Number Of Beneficiaries Age 75 to 84 | 142 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 286 |
| Number Of Male Beneficiaries | 307 |
| Number Of Non Hispanic White Beneficiaries | 582 |
| Number Of Black or African American Beneficiaries | |
| 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 | 370 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 223 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.9662 |