| National Provider Identifier [NPI]: | 1841441789 |
| Last Name Of The Provider | PHAM |
| First Name Of The Provider | KIM-ANH |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2101 W SPRING CREEK PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | PLANO |
| Zip Code Of The Provider | 750234103 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 241 |
| Number Of Medicare Beneficiaries | 128 |
| Total Submitted Charge Amount | 9679.17 |
| Total Medicare Allowed Amount | 8577.38 |
| Total Medicare Payment Amount | 6987.91 |
| Total Medicare Standardized Payment Amount | 8097.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 84 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 2601.17 |
| Total Drug Medicare AllowedAmount | 2541.89 |
| Total Drug Medicare PaymentAmount | 2462.43 |
| Total Drug Medicare Standardized Payment Amount | 2462.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 157 |
| Number Of Medicare Beneficiaries With Medical Services | 127 |
| Total Medical Submitted Charge Amount | 7078 |
| Total Medical Medicare Allowed Amount | 6035.49 |
| Total Medical Medicare Payment Amount | 4525.48 |
| Total Medical Medicare Standardized Payment Amount | 5634.58 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 101 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 75 |
| Number Of Male Beneficiaries | 53 |
| Number Of Non Hispanic White Beneficiaries | 105 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 25 |
| 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 | 0.665 |