| National Provider Identifier [NPI]: | 1447257308 |
| Last Name Of The Provider | CULLEN |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 555 BLACK OAK DR |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MEDFORD |
| Zip Code Of The Provider | 975048447 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 182 |
| Number Of Services | 9827 |
| Number Of Medicare Beneficiaries | 568 |
| Total Submitted Charge Amount | 546844 |
| Total Medicare Allowed Amount | 217598.86 |
| Total Medicare Payment Amount | 158687.77 |
| Total Medicare Standardized Payment Amount | 170319.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 20 |
| Number Of Drug Services | 3200 |
| Number Of Medicare Beneficiaries With Drug Services | 59 |
| Total Drug Submitted ChargeAmount | 8510 |
| Total Drug Medicare AllowedAmount | 4203.71 |
| Total Drug Medicare PaymentAmount | 3296.97 |
| Total Drug Medicare Standardized Payment Amount | 3296.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 162 |
| Number Of Medical Services | 6627 |
| Number Of Medicare Beneficiaries With Medical Services | 568 |
| Total Medical Submitted Charge Amount | 538334 |
| Total Medical Medicare Allowed Amount | 213395.15 |
| Total Medical Medicare Payment Amount | 155390.8 |
| Total Medical Medicare Standardized Payment Amount | 167022.94 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 111 |
| Number Of Beneficiaries Age 65 to 74 | 228 |
| Number Of Beneficiaries Age 75 to 84 | 141 |
| Number Of Beneficiaries Age Greater 84 | 88 |
| Number Of Female Beneficiaries | 306 |
| Number Of Male Beneficiaries | 262 |
| Number Of Non Hispanic White Beneficiaries | 528 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 471 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 97 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2975 |