| National Provider Identifier [NPI]: | 1336110592 |
| Last Name Of The Provider | RATANAPANICHKICH |
| First Name Of The Provider | PITI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4600 INVESTMENT DR |
| Street Address 2 Of The Provider | STE 290 |
| City Of The Provider | TROY |
| Zip Code Of The Provider | 48098 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 5094 |
| Number Of Medicare Beneficiaries | 959 |
| Total Submitted Charge Amount | 1158588 |
| Total Medicare Allowed Amount | 456647.84 |
| Total Medicare Payment Amount | 352477.12 |
| Total Medicare Standardized Payment Amount | 343376.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1171 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 46840 |
| Total Drug Medicare AllowedAmount | 13463.23 |
| Total Drug Medicare PaymentAmount | 10204.23 |
| Total Drug Medicare Standardized Payment Amount | 10204.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 3923 |
| Number Of Medicare Beneficiaries With Medical Services | 959 |
| Total Medical Submitted Charge Amount | 1111748 |
| Total Medical Medicare Allowed Amount | 443184.61 |
| Total Medical Medicare Payment Amount | 342272.89 |
| Total Medical Medicare Standardized Payment Amount | 333172.76 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 172 |
| Number Of Beneficiaries Age 65 to 74 | 278 |
| Number Of Beneficiaries Age 75 to 84 | 329 |
| Number Of Beneficiaries Age Greater 84 | 180 |
| Number Of Female Beneficiaries | 431 |
| Number Of Male Beneficiaries | 528 |
| Number Of Non Hispanic White Beneficiaries | 757 |
| Number Of Black or African American Beneficiaries | 130 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 758 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 201 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 66 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 4.1516 |