| National Provider Identifier [NPI]: | 1497847206 |
| Last Name Of The Provider | CHARNVITAYAPONG |
| First Name Of The Provider | KASEM |
| 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 | 2221 SE OCEAN BLVD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | STUART |
| Zip Code Of The Provider | 349963341 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 5088 |
| Number Of Medicare Beneficiaries | 1176 |
| Total Submitted Charge Amount | 610811 |
| Total Medicare Allowed Amount | 552089.69 |
| Total Medicare Payment Amount | 424240.7 |
| Total Medicare Standardized Payment Amount | 377425.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 19 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 246 |
| Total Drug Medicare AllowedAmount | 79.07 |
| Total Drug Medicare PaymentAmount | 60.61 |
| Total Drug Medicare Standardized Payment Amount | 60.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 5069 |
| Number Of Medicare Beneficiaries With Medical Services | 1176 |
| Total Medical Submitted Charge Amount | 610565 |
| Total Medical Medicare Allowed Amount | 552010.62 |
| Total Medical Medicare Payment Amount | 424180.09 |
| Total Medical Medicare Standardized Payment Amount | 377365.25 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 76 |
| Number Of Beneficiaries Age 65 to 74 | 330 |
| Number Of Beneficiaries Age 75 to 84 | 483 |
| Number Of Beneficiaries Age Greater 84 | 287 |
| Number Of Female Beneficiaries | 638 |
| Number Of Male Beneficiaries | 538 |
| Number Of Non Hispanic White Beneficiaries | 1103 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1073 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 103 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 29 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 69 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.1195 |