| National Provider Identifier [NPI]: | 1619273737 |
| Last Name Of The Provider | ARIYAVATKUL |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1579 STRAITS TPKE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MIDDLEBURY |
| Zip Code Of The Provider | 067621835 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 4378 |
| Number Of Medicare Beneficiaries | 411 |
| Total Submitted Charge Amount | 948543.97 |
| Total Medicare Allowed Amount | 104839.12 |
| Total Medicare Payment Amount | 78767.75 |
| Total Medicare Standardized Payment Amount | 78159.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 3448 |
| Number Of Medicare Beneficiaries With Drug Services | 153 |
| Total Drug Submitted ChargeAmount | 64454.47 |
| Total Drug Medicare AllowedAmount | 46212.6 |
| Total Drug Medicare PaymentAmount | 36030.17 |
| Total Drug Medicare Standardized Payment Amount | 36030.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 930 |
| Number Of Medicare Beneficiaries With Medical Services | 411 |
| Total Medical Submitted Charge Amount | 884089.5 |
| Total Medical Medicare Allowed Amount | 58626.52 |
| Total Medical Medicare Payment Amount | 42737.58 |
| Total Medical Medicare Standardized Payment Amount | 42129.68 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 191 |
| Number Of Beneficiaries Age 75 to 84 | 143 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 275 |
| Number Of Male Beneficiaries | 136 |
| Number Of Non Hispanic White Beneficiaries | 385 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 370 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0428 |