| National Provider Identifier [NPI]: | 1942324397 |
| Last Name Of The Provider | ULLAL |
| First Name Of The Provider | RITU |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 208 ROBINSON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | HUDSON |
| Zip Code Of The Provider | 030513059 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 230 |
| Number Of Medicare Beneficiaries | 71 |
| Total Submitted Charge Amount | 50256.27 |
| Total Medicare Allowed Amount | 19596.18 |
| Total Medicare Payment Amount | 13486.25 |
| Total Medicare Standardized Payment Amount | 13412.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 2239.27 |
| Total Drug Medicare AllowedAmount | 731.46 |
| Total Drug Medicare PaymentAmount | 703.31 |
| Total Drug Medicare Standardized Payment Amount | 703.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 204 |
| Number Of Medicare Beneficiaries With Medical Services | 71 |
| Total Medical Submitted Charge Amount | 48017 |
| Total Medical Medicare Allowed Amount | 18864.72 |
| Total Medical Medicare Payment Amount | 12782.94 |
| Total Medical Medicare Standardized Payment Amount | 12709.14 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 34 |
| Number Of Beneficiaries Age 75 to 84 | 20 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 51 |
| Number Of Male Beneficiaries | 20 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 56 |
| 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 | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8789 |