| National Provider Identifier [NPI]: | 1831205707 |
| Last Name Of The Provider | PHAM |
| First Name Of The Provider | TRI |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5985 COLUMBIA PIKE |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | FALLS CHURCH |
| Zip Code Of The Provider | 22041 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 2035 |
| Number Of Medicare Beneficiaries | 266 |
| Total Submitted Charge Amount | 215492 |
| Total Medicare Allowed Amount | 173699.92 |
| Total Medicare Payment Amount | 127302.75 |
| Total Medicare Standardized Payment Amount | 115843.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 38 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 1900 |
| Total Drug Medicare AllowedAmount | 585.2 |
| Total Drug Medicare PaymentAmount | 573.42 |
| Total Drug Medicare Standardized Payment Amount | 573.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 1997 |
| Number Of Medicare Beneficiaries With Medical Services | 266 |
| Total Medical Submitted Charge Amount | 213592 |
| Total Medical Medicare Allowed Amount | 173114.72 |
| Total Medical Medicare Payment Amount | 126729.33 |
| Total Medical Medicare Standardized Payment Amount | 115269.97 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 90 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 156 |
| Number Of Male Beneficiaries | 110 |
| Number Of Non Hispanic White Beneficiaries | 94 |
| Number Of Black or African American Beneficiaries | 45 |
| Number Of AsianPacific Islander Beneficiaries | 92 |
| 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 | 121 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 145 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6163 |