| National Provider Identifier [NPI]: | 1538188057 |
| Last Name Of The Provider | PHAM |
| First Name Of The Provider | THONG |
| Middle Initial Of The Provider | Q |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5885 SUNNYBROOK DR |
| Street Address 2 Of The Provider | SUITE L-200 |
| City Of The Provider | SIOUX CITY |
| Zip Code Of The Provider | 511064203 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 7401 |
| Number Of Medicare Beneficiaries | 3715 |
| Total Submitted Charge Amount | 893678.8 |
| Total Medicare Allowed Amount | 328494.24 |
| Total Medicare Payment Amount | 252063.9 |
| Total Medicare Standardized Payment Amount | 272950.49 |
| 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 | 82 |
| Number Of Medical Services | 7401 |
| Number Of Medicare Beneficiaries With Medical Services | 3715 |
| Total Medical Submitted Charge Amount | 893678.8 |
| Total Medical Medicare Allowed Amount | 328494.24 |
| Total Medical Medicare Payment Amount | 252063.9 |
| Total Medical Medicare Standardized Payment Amount | 272950.49 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 390 |
| Number Of Beneficiaries Age 65 to 74 | 1076 |
| Number Of Beneficiaries Age 75 to 84 | 1281 |
| Number Of Beneficiaries Age Greater 84 | 968 |
| Number Of Female Beneficiaries | 1992 |
| Number Of Male Beneficiaries | 1723 |
| Number Of Non Hispanic White Beneficiaries | 3564 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | 28 |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2994 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 721 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4774 |