| National Provider Identifier [NPI]: | 1457383879 |
| Last Name Of The Provider | DAMRONGPIPATKIJ |
| First Name Of The Provider | YUDTHSAK |
| 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 | 1330 ROCKEFELLER AVE |
| Street Address 2 Of The Provider | STE 310 |
| City Of The Provider | EVERETT |
| Zip Code Of The Provider | 982011684 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 3029.5 |
| Number Of Medicare Beneficiaries | 1240 |
| Total Submitted Charge Amount | 681139.7 |
| Total Medicare Allowed Amount | 257792.15 |
| Total Medicare Payment Amount | 192666.26 |
| Total Medicare Standardized Payment Amount | 196003.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 126.5 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 11663.5 |
| Total Drug Medicare AllowedAmount | 6542.98 |
| Total Drug Medicare PaymentAmount | 4969.23 |
| Total Drug Medicare Standardized Payment Amount | 4969.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 2903 |
| Number Of Medicare Beneficiaries With Medical Services | 1240 |
| Total Medical Submitted Charge Amount | 669476.2 |
| Total Medical Medicare Allowed Amount | 251249.17 |
| Total Medical Medicare Payment Amount | 187697.03 |
| Total Medical Medicare Standardized Payment Amount | 191034.68 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 115 |
| Number Of Beneficiaries Age 65 to 74 | 482 |
| Number Of Beneficiaries Age 75 to 84 | 425 |
| Number Of Beneficiaries Age Greater 84 | 218 |
| Number Of Female Beneficiaries | 585 |
| Number Of Male Beneficiaries | 655 |
| Number Of Non Hispanic White Beneficiaries | 1152 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1074 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 166 |
| Percent Of With Atrial Fibrillation | 42 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5135 |