| National Provider Identifier [NPI]: | 1255329371 |
| Last Name Of The Provider | SONGCHAROEN |
| First Name Of The Provider | SUTHIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2550 FLOWOOD DR |
| Street Address 2 Of The Provider | #300 |
| City Of The Provider | FLOWOOD |
| Zip Code Of The Provider | 392329303 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 130 |
| Number Of Services | 356324 |
| Number Of Medicare Beneficiaries | 822 |
| Total Submitted Charge Amount | 8340482 |
| Total Medicare Allowed Amount | 5540803 |
| Total Medicare Payment Amount | 4271250.14 |
| Total Medicare Standardized Payment Amount | 4316132.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 326130 |
| Number Of Medicare Beneficiaries With Drug Services | 392 |
| Total Drug Submitted ChargeAmount | 6691230 |
| Total Drug Medicare AllowedAmount | 4887150.35 |
| Total Drug Medicare PaymentAmount | 3769172.14 |
| Total Drug Medicare Standardized Payment Amount | 3769172.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 111 |
| Number Of Medical Services | 30194 |
| Number Of Medicare Beneficiaries With Medical Services | 822 |
| Total Medical Submitted Charge Amount | 1649252 |
| Total Medical Medicare Allowed Amount | 653652.65 |
| Total Medical Medicare Payment Amount | 502078 |
| Total Medical Medicare Standardized Payment Amount | 546960.24 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 123 |
| Number Of Beneficiaries Age 65 to 74 | 413 |
| Number Of Beneficiaries Age 75 to 84 | 251 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 674 |
| Number Of Male Beneficiaries | 148 |
| Number Of Non Hispanic White Beneficiaries | 678 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 783 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 27 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.0387 |