| National Provider Identifier [NPI]: | 1043478183 |
| Last Name Of The Provider | NAMARSA |
| First Name Of The Provider | SOMJIRA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1402 W AVENUE H |
| Street Address 2 Of The Provider | |
| City Of The Provider | TEMPLE |
| Zip Code Of The Provider | 765045342 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 430 |
| Number Of Medicare Beneficiaries | 74 |
| Total Submitted Charge Amount | 89108 |
| Total Medicare Allowed Amount | 22663.49 |
| Total Medicare Payment Amount | 14771.53 |
| Total Medicare Standardized Payment Amount | 15252.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 126 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 1819 |
| Total Drug Medicare AllowedAmount | 239.21 |
| Total Drug Medicare PaymentAmount | 145.95 |
| Total Drug Medicare Standardized Payment Amount | 145.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 304 |
| Number Of Medicare Beneficiaries With Medical Services | 74 |
| Total Medical Submitted Charge Amount | 87289 |
| Total Medical Medicare Allowed Amount | 22424.28 |
| Total Medical Medicare Payment Amount | 14625.58 |
| Total Medical Medicare Standardized Payment Amount | 15106.06 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 47 |
| Number Of Male Beneficiaries | 27 |
| Number Of Non Hispanic White Beneficiaries | 50 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| 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 | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6789 |