| National Provider Identifier [NPI]: | 1992702062 |
| Last Name Of The Provider | LE |
| First Name Of The Provider | QUANG |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2550 RIVER PARK PLZ |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761160920 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 6765 |
| Number Of Medicare Beneficiaries | 1028 |
| Total Submitted Charge Amount | 779727.73 |
| Total Medicare Allowed Amount | 446031.58 |
| Total Medicare Payment Amount | 342070.84 |
| Total Medicare Standardized Payment Amount | 303549.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 420 |
| Number Of Medicare Beneficiaries With Drug Services | 328 |
| Total Drug Submitted ChargeAmount | 9035 |
| Total Drug Medicare AllowedAmount | 4960.71 |
| Total Drug Medicare PaymentAmount | 4843.17 |
| Total Drug Medicare Standardized Payment Amount | 4843.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 6345 |
| Number Of Medicare Beneficiaries With Medical Services | 1028 |
| Total Medical Submitted Charge Amount | 770692.73 |
| Total Medical Medicare Allowed Amount | 441070.87 |
| Total Medical Medicare Payment Amount | 337227.67 |
| Total Medical Medicare Standardized Payment Amount | 298706.22 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 148 |
| Number Of Beneficiaries Age 65 to 74 | 239 |
| Number Of Beneficiaries Age 75 to 84 | 287 |
| Number Of Beneficiaries Age Greater 84 | 354 |
| Number Of Female Beneficiaries | 649 |
| Number Of Male Beneficiaries | 379 |
| Number Of Non Hispanic White Beneficiaries | 856 |
| Number Of Black or African American Beneficiaries | 104 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 782 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 246 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 50 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.2098 |