| National Provider Identifier [NPI]: | 1629035928 |
| Last Name Of The Provider | PHULL |
| First Name Of The Provider | RATTNA |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1180 BEACON STREET |
| Street Address 2 Of The Provider | SUITE 1A-B |
| City Of The Provider | BROOKLINE |
| Zip Code Of The Provider | 02446 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 409 |
| Number Of Medicare Beneficiaries | 174 |
| Total Submitted Charge Amount | 106579 |
| Total Medicare Allowed Amount | 33844.21 |
| Total Medicare Payment Amount | 24397.23 |
| Total Medicare Standardized Payment Amount | 23121.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 59 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 2555 |
| Total Drug Medicare AllowedAmount | 1883.59 |
| Total Drug Medicare PaymentAmount | 1833.38 |
| Total Drug Medicare Standardized Payment Amount | 1833.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 350 |
| Number Of Medicare Beneficiaries With Medical Services | 174 |
| Total Medical Submitted Charge Amount | 104024 |
| Total Medical Medicare Allowed Amount | 31960.62 |
| Total Medical Medicare Payment Amount | 22563.85 |
| Total Medical Medicare Standardized Payment Amount | 21287.67 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 102 |
| Number Of Beneficiaries Age 75 to 84 | 45 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 121 |
| Number Of Male Beneficiaries | 53 |
| Number Of Non Hispanic White Beneficiaries | 155 |
| 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 | 159 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 11 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 41 |
| Percent Of With Ischemic Heart Disease | 11 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7449 |