| National Provider Identifier [NPI]: | 1841344876 |
| Last Name Of The Provider | ANANTACHAI |
| First Name Of The Provider | PRAMOTE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 404 LINCOLN DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HERRIN |
| Zip Code Of The Provider | 62948 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 7449.3 |
| Number Of Medicare Beneficiaries | 1984 |
| Total Submitted Charge Amount | 592702.7 |
| Total Medicare Allowed Amount | 325854.94 |
| Total Medicare Payment Amount | 241484.67 |
| Total Medicare Standardized Payment Amount | 238384.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 216.3 |
| Number Of Medicare Beneficiaries With Drug Services | 141 |
| Total Drug Submitted ChargeAmount | 7260.7 |
| Total Drug Medicare AllowedAmount | 3955.11 |
| Total Drug Medicare PaymentAmount | 3718.94 |
| Total Drug Medicare Standardized Payment Amount | 3718.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 7233 |
| Number Of Medicare Beneficiaries With Medical Services | 1984 |
| Total Medical Submitted Charge Amount | 585442 |
| Total Medical Medicare Allowed Amount | 321899.83 |
| Total Medical Medicare Payment Amount | 237765.73 |
| Total Medical Medicare Standardized Payment Amount | 234665.81 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 394 |
| Number Of Beneficiaries Age 65 to 74 | 693 |
| Number Of Beneficiaries Age 75 to 84 | 575 |
| Number Of Beneficiaries Age Greater 84 | 322 |
| Number Of Female Beneficiaries | 1283 |
| Number Of Male Beneficiaries | 701 |
| Number Of Non Hispanic White Beneficiaries | 1919 |
| Number Of Black or African American Beneficiaries | 20 |
| 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 | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1355 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 629 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6013 |