| National Provider Identifier [NPI]: | 1184609885 |
| Last Name Of The Provider | TRAN |
| First Name Of The Provider | PHONG |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15606 BROOKHURST ST |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | WESTMINSTER |
| Zip Code Of The Provider | 926837581 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 14013 |
| Number Of Medicare Beneficiaries | 656 |
| Total Submitted Charge Amount | 1936997 |
| Total Medicare Allowed Amount | 791718.76 |
| Total Medicare Payment Amount | 592645.25 |
| Total Medicare Standardized Payment Amount | 520038.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 5070 |
| Number Of Medicare Beneficiaries With Drug Services | 592 |
| Total Drug Submitted ChargeAmount | 133790 |
| Total Drug Medicare AllowedAmount | 23946.34 |
| Total Drug Medicare PaymentAmount | 19011.57 |
| Total Drug Medicare Standardized Payment Amount | 19011.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 8943 |
| Number Of Medicare Beneficiaries With Medical Services | 656 |
| Total Medical Submitted Charge Amount | 1803207 |
| Total Medical Medicare Allowed Amount | 767772.42 |
| Total Medical Medicare Payment Amount | 573633.68 |
| Total Medical Medicare Standardized Payment Amount | 501026.73 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 284 |
| Number Of Beneficiaries Age 75 to 84 | 253 |
| Number Of Beneficiaries Age Greater 84 | 75 |
| Number Of Female Beneficiaries | 369 |
| Number Of Male Beneficiaries | 287 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 631 |
| 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 | 37 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 619 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.355 |