| National Provider Identifier [NPI]: | 1619940194 |
| Last Name Of The Provider | SOMPHONE |
| First Name Of The Provider | EUGENE |
| 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 | 888 S RANCHO DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 89106 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 200 |
| Number Of Medicare Beneficiaries | 72 |
| Total Submitted Charge Amount | 18088 |
| Total Medicare Allowed Amount | 8391.74 |
| Total Medicare Payment Amount | 5067.32 |
| Total Medicare Standardized Payment Amount | 5494.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 37 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 170 |
| Total Drug Medicare AllowedAmount | 73.07 |
| Total Drug Medicare PaymentAmount | 57.14 |
| Total Drug Medicare Standardized Payment Amount | 57.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 163 |
| Number Of Medicare Beneficiaries With Medical Services | 72 |
| Total Medical Submitted Charge Amount | 17918 |
| Total Medical Medicare Allowed Amount | 8318.67 |
| Total Medical Medicare Payment Amount | 5010.18 |
| Total Medical Medicare Standardized Payment Amount | 5436.97 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 30 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 49 |
| Number Of Male Beneficiaries | 23 |
| Number Of Non Hispanic White Beneficiaries | 31 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 45 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8329 |