| National Provider Identifier [NPI]: | 1689615221 |
| Last Name Of The Provider | PHAM |
| First Name Of The Provider | DUC |
| Middle Initial Of The Provider | Q |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 26800 CROWN VALLEY PKWY |
| Street Address 2 Of The Provider | SUITE 315 |
| City Of The Provider | MISSION VIEJO |
| Zip Code Of The Provider | 926916384 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 7852 |
| Number Of Medicare Beneficiaries | 562 |
| Total Submitted Charge Amount | 455979 |
| Total Medicare Allowed Amount | 258067.69 |
| Total Medicare Payment Amount | 208257 |
| Total Medicare Standardized Payment Amount | 197211.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 747 |
| Number Of Medicare Beneficiaries With Drug Services | 272 |
| Total Drug Submitted ChargeAmount | 51025 |
| Total Drug Medicare AllowedAmount | 25371.99 |
| Total Drug Medicare PaymentAmount | 24550.17 |
| Total Drug Medicare Standardized Payment Amount | 24550.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 7105 |
| Number Of Medicare Beneficiaries With Medical Services | 562 |
| Total Medical Submitted Charge Amount | 404954 |
| Total Medical Medicare Allowed Amount | 232695.7 |
| Total Medical Medicare Payment Amount | 183706.83 |
| Total Medical Medicare Standardized Payment Amount | 172661.76 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 210 |
| Number Of Beneficiaries Age 75 to 84 | 215 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 246 |
| Number Of Male Beneficiaries | 316 |
| Number Of Non Hispanic White Beneficiaries | 502 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 542 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.1901 |