| National Provider Identifier [NPI]: | 1578767992 |
| Last Name Of The Provider | TRAN |
| First Name Of The Provider | VYTHAO |
| 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 | 725 WELCH RD RM 16814 |
| Street Address 2 Of The Provider | LUCILE PACKARD CHILDRENS HOSPITAL DEPT. OF RADIOLOGY |
| City Of The Provider | PALO ALTO |
| Zip Code Of The Provider | 943041601 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 174 |
| Number Of Services | 3080 |
| Number Of Medicare Beneficiaries | 2063 |
| Total Submitted Charge Amount | 293525.17 |
| Total Medicare Allowed Amount | 95826.84 |
| Total Medicare Payment Amount | 74735.54 |
| Total Medicare Standardized Payment Amount | 73691.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 174 |
| Number Of Medical Services | 3080 |
| Number Of Medicare Beneficiaries With Medical Services | 2063 |
| Total Medical Submitted Charge Amount | 293525.17 |
| Total Medical Medicare Allowed Amount | 95826.84 |
| Total Medical Medicare Payment Amount | 74735.54 |
| Total Medical Medicare Standardized Payment Amount | 73691.07 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 556 |
| Number Of Beneficiaries Age 65 to 74 | 665 |
| Number Of Beneficiaries Age 75 to 84 | 532 |
| Number Of Beneficiaries Age Greater 84 | 310 |
| Number Of Female Beneficiaries | 1121 |
| Number Of Male Beneficiaries | 942 |
| Number Of Non Hispanic White Beneficiaries | 872 |
| Number Of Black or African American Beneficiaries | 341 |
| Number Of AsianPacific Islander Beneficiaries | 135 |
| Number Of Hispanic Beneficiaries | 680 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 715 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1348 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.622 |