| National Provider Identifier [NPI]: | 1114963170 |
| Last Name Of The Provider | RULLAN |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 256 LANDIS AVE |
| Street Address 2 Of The Provider | 3RD FLOOR |
| City Of The Provider | CHULA VISTA |
| Zip Code Of The Provider | 919102650 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 125 |
| Number Of Services | 8379 |
| Number Of Medicare Beneficiaries | 991 |
| Total Submitted Charge Amount | 1103043 |
| Total Medicare Allowed Amount | 659448.85 |
| Total Medicare Payment Amount | 491195.41 |
| Total Medicare Standardized Payment Amount | 445643.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 832 |
| Number Of Medicare Beneficiaries With Drug Services | 290 |
| Total Drug Submitted ChargeAmount | 16185 |
| Total Drug Medicare AllowedAmount | 8929.76 |
| Total Drug Medicare PaymentAmount | 6694.26 |
| Total Drug Medicare Standardized Payment Amount | 6694.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 121 |
| Number Of Medical Services | 7547 |
| Number Of Medicare Beneficiaries With Medical Services | 991 |
| Total Medical Submitted Charge Amount | 1086858 |
| Total Medical Medicare Allowed Amount | 650519.09 |
| Total Medical Medicare Payment Amount | 484501.15 |
| Total Medical Medicare Standardized Payment Amount | 438948.82 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 384 |
| Number Of Beneficiaries Age 75 to 84 | 352 |
| Number Of Beneficiaries Age Greater 84 | 170 |
| Number Of Female Beneficiaries | 553 |
| Number Of Male Beneficiaries | 438 |
| Number Of Non Hispanic White Beneficiaries | 534 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 61 |
| Number Of Hispanic Beneficiaries | 342 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 669 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 322 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.42 |