| National Provider Identifier [NPI]: | 1669461521 |
| Last Name Of The Provider | VO |
| First Name Of The Provider | THUYNGOC |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1125 E SOUTHERN AVE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | MESA |
| Zip Code Of The Provider | 852045045 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 3616 |
| Number Of Medicare Beneficiaries | 1405 |
| Total Submitted Charge Amount | 640488.7 |
| Total Medicare Allowed Amount | 260820.18 |
| Total Medicare Payment Amount | 221653.65 |
| Total Medicare Standardized Payment Amount | 224108.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 601 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 3500.7 |
| Total Drug Medicare AllowedAmount | 1189.71 |
| Total Drug Medicare PaymentAmount | 932.82 |
| Total Drug Medicare Standardized Payment Amount | 932.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 3015 |
| Number Of Medicare Beneficiaries With Medical Services | 1405 |
| Total Medical Submitted Charge Amount | 636988 |
| Total Medical Medicare Allowed Amount | 259630.47 |
| Total Medical Medicare Payment Amount | 220720.83 |
| Total Medical Medicare Standardized Payment Amount | 223175.33 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 831 |
| Number Of Beneficiaries Age 75 to 84 | 432 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 1392 |
| Number Of Male Beneficiaries | 13 |
| Number Of Non Hispanic White Beneficiaries | 1290 |
| Number Of Black or African American Beneficiaries | 31 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1374 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.7927 |