| National Provider Identifier [NPI]: | 1649474222 |
| Last Name Of The Provider | PHAN |
| First Name Of The Provider | NGHI |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2831 E PRESIDENT GEORGE BUSH HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | RICHARDSON |
| Zip Code Of The Provider | 750823561 |
| 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 | 14 |
| Number Of Services | 1753 |
| Number Of Medicare Beneficiaries | 406 |
| Total Submitted Charge Amount | 276193 |
| Total Medicare Allowed Amount | 189786.87 |
| Total Medicare Payment Amount | 147650.98 |
| Total Medicare Standardized Payment Amount | 151691.79 |
| 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 | 14 |
| Number Of Medical Services | 1753 |
| Number Of Medicare Beneficiaries With Medical Services | 406 |
| Total Medical Submitted Charge Amount | 276193 |
| Total Medical Medicare Allowed Amount | 189786.87 |
| Total Medical Medicare Payment Amount | 147650.98 |
| Total Medical Medicare Standardized Payment Amount | 151691.79 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 129 |
| Number Of Beneficiaries Age 75 to 84 | 125 |
| Number Of Beneficiaries Age Greater 84 | 116 |
| Number Of Female Beneficiaries | 238 |
| Number Of Male Beneficiaries | 168 |
| Number Of Non Hispanic White Beneficiaries | 318 |
| Number Of Black or African American Beneficiaries | 33 |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| 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 | 299 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 107 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 38 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.2127 |