| National Provider Identifier [NPI]: | 1245398619 |
| Last Name Of The Provider | MUANGMAN |
| First Name Of The Provider | SUPHICHAYA |
| 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 | 1625 STRAITS TPKE |
| Street Address 2 Of The Provider | SUITE 209 |
| City Of The Provider | MIDDLEBURY |
| Zip Code Of The Provider | 067621836 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 5732 |
| Number Of Medicare Beneficiaries | 2277 |
| Total Submitted Charge Amount | 988016.2 |
| Total Medicare Allowed Amount | 336472.67 |
| Total Medicare Payment Amount | 256976.08 |
| Total Medicare Standardized Payment Amount | 243209.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 49 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 3725 |
| Total Drug Medicare AllowedAmount | 2546.13 |
| Total Drug Medicare PaymentAmount | 1996.13 |
| Total Drug Medicare Standardized Payment Amount | 1996.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 5683 |
| Number Of Medicare Beneficiaries With Medical Services | 2277 |
| Total Medical Submitted Charge Amount | 984291.2 |
| Total Medical Medicare Allowed Amount | 333926.54 |
| Total Medical Medicare Payment Amount | 254979.95 |
| Total Medical Medicare Standardized Payment Amount | 241213.12 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 438 |
| Number Of Beneficiaries Age 65 to 74 | 570 |
| Number Of Beneficiaries Age 75 to 84 | 680 |
| Number Of Beneficiaries Age Greater 84 | 589 |
| Number Of Female Beneficiaries | 1323 |
| Number Of Male Beneficiaries | 954 |
| Number Of Non Hispanic White Beneficiaries | 1787 |
| Number Of Black or African American Beneficiaries | 193 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 242 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1123 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1154 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.9819 |