| National Provider Identifier [NPI]: | 1134163793 |
| Last Name Of The Provider | PHAM |
| First Name Of The Provider | TUAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9333 BASELINE RD |
| Street Address 2 Of The Provider | STE. 160 |
| City Of The Provider | RANCHO CUCAMONGA |
| Zip Code Of The Provider | 917301354 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 4196.2 |
| Number Of Medicare Beneficiaries | 895 |
| Total Submitted Charge Amount | 1139038.13 |
| Total Medicare Allowed Amount | 399924.54 |
| Total Medicare Payment Amount | 301984.94 |
| Total Medicare Standardized Payment Amount | 292301.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 362.2 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 53500 |
| Total Drug Medicare AllowedAmount | 13412.84 |
| Total Drug Medicare PaymentAmount | 10515.65 |
| Total Drug Medicare Standardized Payment Amount | 10515.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 3834 |
| Number Of Medicare Beneficiaries With Medical Services | 895 |
| Total Medical Submitted Charge Amount | 1085538.13 |
| Total Medical Medicare Allowed Amount | 386511.7 |
| Total Medical Medicare Payment Amount | 291469.29 |
| Total Medical Medicare Standardized Payment Amount | 281786.32 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 309 |
| Number Of Beneficiaries Age 75 to 84 | 295 |
| Number Of Beneficiaries Age Greater 84 | 167 |
| Number Of Female Beneficiaries | 518 |
| Number Of Male Beneficiaries | 377 |
| Number Of Non Hispanic White Beneficiaries | 481 |
| Number Of Black or African American Beneficiaries | 71 |
| Number Of AsianPacific Islander Beneficiaries | 96 |
| Number Of Hispanic Beneficiaries | 223 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 502 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 393 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.37 |