| National Provider Identifier [NPI]: | 1801959069 |
| Last Name Of The Provider | MAHAISAVARIYA |
| First Name Of The Provider | PAIBOON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8317 DAVIS STREET |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | DOWNEY |
| Zip Code Of The Provider | 902415021 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 2850 |
| Number Of Medicare Beneficiaries | 731 |
| Total Submitted Charge Amount | 629485 |
| Total Medicare Allowed Amount | 284770.36 |
| Total Medicare Payment Amount | 215919.74 |
| Total Medicare Standardized Payment Amount | 200434.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 239 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 28545 |
| Total Drug Medicare AllowedAmount | 10195.67 |
| Total Drug Medicare PaymentAmount | 7801.9 |
| Total Drug Medicare Standardized Payment Amount | 7801.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 2611 |
| Number Of Medicare Beneficiaries With Medical Services | 731 |
| Total Medical Submitted Charge Amount | 600940 |
| Total Medical Medicare Allowed Amount | 274574.69 |
| Total Medical Medicare Payment Amount | 208117.84 |
| Total Medical Medicare Standardized Payment Amount | 192632.97 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 235 |
| Number Of Beneficiaries Age 75 to 84 | 235 |
| Number Of Beneficiaries Age Greater 84 | 154 |
| Number Of Female Beneficiaries | 424 |
| Number Of Male Beneficiaries | 307 |
| Number Of Non Hispanic White Beneficiaries | 167 |
| Number Of Black or African American Beneficiaries | 98 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 443 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 195 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 536 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 60 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 63 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.9141 |