| National Provider Identifier [NPI]: | 1831350131 |
| Last Name Of The Provider | TRAN |
| First Name Of The Provider | TIFFANY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12408 HESPERIA RD |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | VICTORVILLE |
| Zip Code Of The Provider | 923957718 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 378.5 |
| Number Of Medicare Beneficiaries | 103 |
| Total Submitted Charge Amount | 21158.3 |
| Total Medicare Allowed Amount | 18837.92 |
| Total Medicare Payment Amount | 13196.23 |
| Total Medicare Standardized Payment Amount | 13172.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 63 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 1885 |
| Total Drug Medicare AllowedAmount | 990.92 |
| Total Drug Medicare PaymentAmount | 951.03 |
| Total Drug Medicare Standardized Payment Amount | 951.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 315.5 |
| Number Of Medicare Beneficiaries With Medical Services | 102 |
| Total Medical Submitted Charge Amount | 19273.3 |
| Total Medical Medicare Allowed Amount | 17847 |
| Total Medical Medicare Payment Amount | 12245.2 |
| Total Medical Medicare Standardized Payment Amount | 12221.34 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 50 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 72 |
| Number Of Male Beneficiaries | 31 |
| Number Of Non Hispanic White Beneficiaries | 73 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 81 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2036 |