| National Provider Identifier [NPI]: | 1336192756 |
| Last Name Of The Provider | PULLER |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3601 W COMMERCIAL BLVD |
| Street Address 2 Of The Provider | SUITE 20 |
| City Of The Provider | FORT LAUDERDALE |
| Zip Code Of The Provider | 333093300 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 180 |
| Number Of Services | 10735 |
| Number Of Medicare Beneficiaries | 3014 |
| Total Submitted Charge Amount | 1078701.89 |
| Total Medicare Allowed Amount | 273144.49 |
| Total Medicare Payment Amount | 213398.62 |
| Total Medicare Standardized Payment Amount | 205553.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 5667 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 13686.67 |
| Total Drug Medicare AllowedAmount | 1581.76 |
| Total Drug Medicare PaymentAmount | 1240.07 |
| Total Drug Medicare Standardized Payment Amount | 1240.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 178 |
| Number Of Medical Services | 5068 |
| Number Of Medicare Beneficiaries With Medical Services | 3014 |
| Total Medical Submitted Charge Amount | 1065015.22 |
| Total Medical Medicare Allowed Amount | 271562.73 |
| Total Medical Medicare Payment Amount | 212158.55 |
| Total Medical Medicare Standardized Payment Amount | 204313.41 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 646 |
| Number Of Beneficiaries Age 65 to 74 | 873 |
| Number Of Beneficiaries Age 75 to 84 | 833 |
| Number Of Beneficiaries Age Greater 84 | 662 |
| Number Of Female Beneficiaries | 1810 |
| Number Of Male Beneficiaries | 1204 |
| Number Of Non Hispanic White Beneficiaries | 1609 |
| Number Of Black or African American Beneficiaries | 815 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 503 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1507 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1507 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.2262 |