| National Provider Identifier [NPI]: | 1689899601 |
| Last Name Of The Provider | PHAN |
| First Name Of The Provider | DAN |
| 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 | 5301 VIRGINIA WAY |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | BRENTWOOD |
| Zip Code Of The Provider | 370277541 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 5317 |
| Number Of Medicare Beneficiaries | 2246 |
| Total Submitted Charge Amount | 906046.97 |
| Total Medicare Allowed Amount | 276893.34 |
| Total Medicare Payment Amount | 214305.71 |
| Total Medicare Standardized Payment Amount | 164536 |
| 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 | 46 |
| Number Of Medical Services | 5317 |
| Number Of Medicare Beneficiaries With Medical Services | 2246 |
| Total Medical Submitted Charge Amount | 906046.97 |
| Total Medical Medicare Allowed Amount | 276893.34 |
| Total Medical Medicare Payment Amount | 214305.71 |
| Total Medical Medicare Standardized Payment Amount | 164536 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 444 |
| Number Of Beneficiaries Age 65 to 74 | 1197 |
| Number Of Beneficiaries Age 75 to 84 | 507 |
| Number Of Beneficiaries Age Greater 84 | 98 |
| Number Of Female Beneficiaries | 1301 |
| Number Of Male Beneficiaries | 945 |
| Number Of Non Hispanic White Beneficiaries | 1964 |
| Number Of Black or African American Beneficiaries | 222 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1841 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 405 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0422 |