| National Provider Identifier [NPI]: | 1619159712 |
| Last Name Of The Provider | ABDULLIN |
| First Name Of The Provider | MARAT |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 WASON AVE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011071381 |
| 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 | 61 |
| Number Of Services | 2160 |
| Number Of Medicare Beneficiaries | 564 |
| Total Submitted Charge Amount | 405602.02 |
| Total Medicare Allowed Amount | 152328.35 |
| Total Medicare Payment Amount | 119424.06 |
| Total Medicare Standardized Payment Amount | 117864.59 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
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| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 150 |
| Number Of Beneficiaries Age 65 to 74 | 163 |
| Number Of Beneficiaries Age 75 to 84 | 151 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 275 |
| Number Of Male Beneficiaries | 289 |
| Number Of Non Hispanic White Beneficiaries | 446 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 57 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 301 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 263 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 61 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 3.6782 |