National Provider Identifier [NPI]: |
1063623080 |
Last Name Of The Provider |
PHAM |
First Name Of The Provider |
CYNTHIA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10028 WEST RD |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770646324 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
434 |
Number Of Medicare Beneficiaries |
57 |
Total Submitted Charge Amount |
54492 |
Total Medicare Allowed Amount |
23865.26 |
Total Medicare Payment Amount |
16837.69 |
Total Medicare Standardized Payment Amount |
16734.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
31 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
1615 |
Total Drug Medicare AllowedAmount |
606.58 |
Total Drug Medicare PaymentAmount |
587.79 |
Total Drug Medicare Standardized Payment Amount |
587.79 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
403 |
Number Of Medicare Beneficiaries With Medical Services |
57 |
Total Medical Submitted Charge Amount |
52877 |
Total Medical Medicare Allowed Amount |
23258.68 |
Total Medical Medicare Payment Amount |
16249.9 |
Total Medical Medicare Standardized Payment Amount |
16146.39 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
27 |
Number Of Beneficiaries Age 75 to 84 |
14 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
38 |
Number Of Male Beneficiaries |
19 |
Number Of Non Hispanic White Beneficiaries |
31 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
46 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
21 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9488 |