| National Provider Identifier [NPI]: | 1720100712 |
| Last Name Of The Provider | SHULMAN |
| First Name Of The Provider | ELIZA |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 GROSSMAN DR |
| Street Address 2 Of The Provider | FAMILY MEDICINE |
| City Of The Provider | BRAINTREE |
| Zip Code Of The Provider | 021844997 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 1114 |
| Number Of Medicare Beneficiaries | 180 |
| Total Submitted Charge Amount | 62798 |
| Total Medicare Allowed Amount | 48957.04 |
| Total Medicare Payment Amount | 38088.05 |
| Total Medicare Standardized Payment Amount | 36777.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 1992 |
| Total Drug Medicare AllowedAmount | 1203.38 |
| Total Drug Medicare PaymentAmount | 1179.24 |
| Total Drug Medicare Standardized Payment Amount | 1179.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 1080 |
| Number Of Medicare Beneficiaries With Medical Services | 180 |
| Total Medical Submitted Charge Amount | 60806 |
| Total Medical Medicare Allowed Amount | 47753.66 |
| Total Medical Medicare Payment Amount | 36908.81 |
| Total Medical Medicare Standardized Payment Amount | 35598.66 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 75 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 115 |
| Number Of Male Beneficiaries | 65 |
| Number Of Non Hispanic White Beneficiaries | 164 |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 140 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 36 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2601 |