| National Provider Identifier [NPI]: | 1063403061 |
| Last Name Of The Provider | THACH |
| First Name Of The Provider | THAO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 325 N SHILOH RD |
| Street Address 2 Of The Provider | STE. 103 |
| City Of The Provider | GARLAND |
| Zip Code Of The Provider | 750426610 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 4684 |
| Number Of Medicare Beneficiaries | 466 |
| Total Submitted Charge Amount | 937090 |
| Total Medicare Allowed Amount | 425739.14 |
| Total Medicare Payment Amount | 322143.52 |
| Total Medicare Standardized Payment Amount | 320815.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 79 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 8295 |
| Total Drug Medicare AllowedAmount | 5248.95 |
| Total Drug Medicare PaymentAmount | 4012.31 |
| Total Drug Medicare Standardized Payment Amount | 4012.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 4605 |
| Number Of Medicare Beneficiaries With Medical Services | 466 |
| Total Medical Submitted Charge Amount | 928795 |
| Total Medical Medicare Allowed Amount | 420490.19 |
| Total Medical Medicare Payment Amount | 318131.21 |
| Total Medical Medicare Standardized Payment Amount | 316803.26 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 242 |
| Number Of Beneficiaries Age 75 to 84 | 119 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 283 |
| Number Of Male Beneficiaries | 183 |
| Number Of Non Hispanic White Beneficiaries | 90 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 266 |
| Number Of Hispanic Beneficiaries | 62 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 96 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 370 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 23 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1423 |