| National Provider Identifier [NPI]: | 1215138714 |
| Last Name Of The Provider | PHAM |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20303 KERMIER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WALLER |
| Zip Code Of The Provider | 774848743 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 7379 |
| Number Of Medicare Beneficiaries | 506 |
| Total Submitted Charge Amount | 601557.32 |
| Total Medicare Allowed Amount | 460839.68 |
| Total Medicare Payment Amount | 346330.79 |
| Total Medicare Standardized Payment Amount | 305014.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2885 |
| Number Of Medicare Beneficiaries With Drug Services | 441 |
| Total Drug Submitted ChargeAmount | 33798.32 |
| Total Drug Medicare AllowedAmount | 8353.02 |
| Total Drug Medicare PaymentAmount | 6546.83 |
| Total Drug Medicare Standardized Payment Amount | 6546.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 4494 |
| Number Of Medicare Beneficiaries With Medical Services | 506 |
| Total Medical Submitted Charge Amount | 567759 |
| Total Medical Medicare Allowed Amount | 452486.66 |
| Total Medical Medicare Payment Amount | 339783.96 |
| Total Medical Medicare Standardized Payment Amount | 298467.18 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 222 |
| Number Of Beneficiaries Age 75 to 84 | 208 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 304 |
| Number Of Male Beneficiaries | 202 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 494 |
| 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 | 51 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 455 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 26 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1868 |