National Provider Identifier [NPI]: |
1942398342 |
Last Name Of The Provider |
PHAM |
First Name Of The Provider |
QUANG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4725 N. FEDERAL HIGHWAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT LAUDERDALE |
Zip Code Of The Provider |
333084603 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
292 |
Number Of Medicare Beneficiaries |
214 |
Total Submitted Charge Amount |
385612 |
Total Medicare Allowed Amount |
53171.55 |
Total Medicare Payment Amount |
40457.22 |
Total Medicare Standardized Payment Amount |
38824.34 |
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 |
42 |
Number Of Medical Services |
292 |
Number Of Medicare Beneficiaries With Medical Services |
214 |
Total Medical Submitted Charge Amount |
385612 |
Total Medical Medicare Allowed Amount |
53171.55 |
Total Medical Medicare Payment Amount |
40457.22 |
Total Medical Medicare Standardized Payment Amount |
38824.34 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
113 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
183 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
191 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1906 |