| National Provider Identifier [NPI]: | 1437238342 |
| Last Name Of The Provider | PHAN |
| First Name Of The Provider | DENNIS |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 917 BLANCO CIRCLE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SALINAS |
| Zip Code Of The Provider | 939014446 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 46838 |
| Number Of Medicare Beneficiaries | 1087 |
| Total Submitted Charge Amount | 1118048.6 |
| Total Medicare Allowed Amount | 698920.71 |
| Total Medicare Payment Amount | 531802.31 |
| Total Medicare Standardized Payment Amount | 506369.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 39069 |
| Number Of Medicare Beneficiaries With Drug Services | 219 |
| Total Drug Submitted ChargeAmount | 458769.6 |
| Total Drug Medicare AllowedAmount | 248150.21 |
| Total Drug Medicare PaymentAmount | 193629.45 |
| Total Drug Medicare Standardized Payment Amount | 193629.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 7769 |
| Number Of Medicare Beneficiaries With Medical Services | 1087 |
| Total Medical Submitted Charge Amount | 659279 |
| Total Medical Medicare Allowed Amount | 450770.5 |
| Total Medical Medicare Payment Amount | 338172.86 |
| Total Medical Medicare Standardized Payment Amount | 312740.35 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 226 |
| Number Of Beneficiaries Age 65 to 74 | 341 |
| Number Of Beneficiaries Age 75 to 84 | 354 |
| Number Of Beneficiaries Age Greater 84 | 166 |
| Number Of Female Beneficiaries | 556 |
| Number Of Male Beneficiaries | 531 |
| Number Of Non Hispanic White Beneficiaries | 435 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | 70 |
| Number Of Hispanic Beneficiaries | 531 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 625 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 462 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 66 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 3.2742 |