| National Provider Identifier [NPI]: | 1972600237 |
| Last Name Of The Provider | PHAM |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 THE CITY DR S |
| Street Address 2 Of The Provider | RADIOLOGY, BLDG 1, RM 0115, ROUTE 140 |
| City Of The Provider | ORANGE |
| Zip Code Of The Provider | 928683201 |
| 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 | 147 |
| Number Of Services | 4184 |
| Number Of Medicare Beneficiaries | 2472 |
| Total Submitted Charge Amount | 465363 |
| Total Medicare Allowed Amount | 119022.18 |
| Total Medicare Payment Amount | 90006.01 |
| Total Medicare Standardized Payment Amount | 87776.36 |
| 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 | 147 |
| Number Of Medical Services | 4184 |
| Number Of Medicare Beneficiaries With Medical Services | 2472 |
| Total Medical Submitted Charge Amount | 465363 |
| Total Medical Medicare Allowed Amount | 119022.18 |
| Total Medical Medicare Payment Amount | 90006.01 |
| Total Medical Medicare Standardized Payment Amount | 87776.36 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 598 |
| Number Of Beneficiaries Age 65 to 74 | 929 |
| Number Of Beneficiaries Age 75 to 84 | 645 |
| Number Of Beneficiaries Age Greater 84 | 300 |
| Number Of Female Beneficiaries | 1451 |
| Number Of Male Beneficiaries | 1021 |
| Number Of Non Hispanic White Beneficiaries | 1403 |
| Number Of Black or African American Beneficiaries | 294 |
| Number Of AsianPacific Islander Beneficiaries | 132 |
| Number Of Hispanic Beneficiaries | 575 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1465 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1007 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.8405 |