| National Provider Identifier [NPI]: | 1689656605 |
| Last Name Of The Provider | JUMRUSSIRIKUL |
| First Name Of The Provider | PITAYADET |
| 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 | 5880 UNIVERSITY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST DES MOINES |
| Zip Code Of The Provider | 502668209 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Electrophysiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 97 |
| Number Of Services | 10786 |
| Number Of Medicare Beneficiaries | 5621 |
| Total Submitted Charge Amount | 1459656 |
| Total Medicare Allowed Amount | 486242.12 |
| Total Medicare Payment Amount | 369550.25 |
| Total Medicare Standardized Payment Amount | 396838.77 |
| 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 | 97 |
| Number Of Medical Services | 10786 |
| Number Of Medicare Beneficiaries With Medical Services | 5621 |
| Total Medical Submitted Charge Amount | 1459656 |
| Total Medical Medicare Allowed Amount | 486242.12 |
| Total Medical Medicare Payment Amount | 369550.25 |
| Total Medical Medicare Standardized Payment Amount | 396838.77 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 672 |
| Number Of Beneficiaries Age 65 to 74 | 1622 |
| Number Of Beneficiaries Age 75 to 84 | 1944 |
| Number Of Beneficiaries Age Greater 84 | 1383 |
| Number Of Female Beneficiaries | 2806 |
| Number Of Male Beneficiaries | 2815 |
| Number Of Non Hispanic White Beneficiaries | 5354 |
| Number Of Black or African American Beneficiaries | 126 |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 60 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4424 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1197 |
| Percent Of With Atrial Fibrillation | 36 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6891 |