| National Provider Identifier [NPI]: | 1184792418 |
| Last Name Of The Provider | PHAM |
| First Name Of The Provider | DAO |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 406 S 30TH AVE STE 101 |
| Street Address 2 Of The Provider | |
| City Of The Provider | YAKIMA |
| Zip Code Of The Provider | 989023713 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 2595 |
| Number Of Medicare Beneficiaries | 1447 |
| Total Submitted Charge Amount | 702359 |
| Total Medicare Allowed Amount | 264894.94 |
| Total Medicare Payment Amount | 205642.27 |
| Total Medicare Standardized Payment Amount | 211383.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 2595 |
| Number Of Medicare Beneficiaries With Medical Services | 1447 |
| Total Medical Submitted Charge Amount | 702359 |
| Total Medical Medicare Allowed Amount | 264894.94 |
| Total Medical Medicare Payment Amount | 205642.27 |
| Total Medical Medicare Standardized Payment Amount | 211383.94 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 183 |
| Number Of Beneficiaries Age 65 to 74 | 520 |
| Number Of Beneficiaries Age 75 to 84 | 467 |
| Number Of Beneficiaries Age Greater 84 | 277 |
| Number Of Female Beneficiaries | 718 |
| Number Of Male Beneficiaries | 729 |
| Number Of Non Hispanic White Beneficiaries | 1259 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 117 |
| Number Of American Indian Alaska Native Beneficiaries | 47 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1104 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 343 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5525 |