| National Provider Identifier [NPI]: | 1396050746 |
| Last Name Of The Provider | THEPYASUWAN |
| First Name Of The Provider | NATTAPAUN |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8700 BEVERLY BLVD |
| Street Address 2 Of The Provider | ROOM 5512 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 90048 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 2264 |
| Number Of Medicare Beneficiaries | 467 |
| Total Submitted Charge Amount | 853450 |
| Total Medicare Allowed Amount | 292952.88 |
| Total Medicare Payment Amount | 228240.48 |
| Total Medicare Standardized Payment Amount | 214838.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 2264 |
| Number Of Medicare Beneficiaries With Medical Services | 467 |
| Total Medical Submitted Charge Amount | 853450 |
| Total Medical Medicare Allowed Amount | 292952.88 |
| Total Medical Medicare Payment Amount | 228240.48 |
| Total Medical Medicare Standardized Payment Amount | 214838.49 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 115 |
| Number Of Beneficiaries Age 75 to 84 | 137 |
| Number Of Beneficiaries Age Greater 84 | 186 |
| Number Of Female Beneficiaries | 249 |
| Number Of Male Beneficiaries | 218 |
| Number Of Non Hispanic White Beneficiaries | 342 |
| Number Of Black or African American Beneficiaries | 63 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 297 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 170 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 68 |
| Percent Of With Chronic Kidney Disease | 64 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 22 |
| Average HCC Risk Score Of Beneficiaries | 3.0053 |