| National Provider Identifier [NPI]: | 1578579728 |
| Last Name Of The Provider | PHAM |
| First Name Of The Provider | DUKE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1750 NORTH HAMPTON ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DESOTO |
| Zip Code Of The Provider | 75115 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 152 |
| Number Of Services | 9642 |
| Number Of Medicare Beneficiaries | 1921 |
| Total Submitted Charge Amount | 720604 |
| Total Medicare Allowed Amount | 137740.24 |
| Total Medicare Payment Amount | 103885.58 |
| Total Medicare Standardized Payment Amount | 107192.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 6562 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 7639 |
| Total Drug Medicare AllowedAmount | 1748.72 |
| Total Drug Medicare PaymentAmount | 1338.3 |
| Total Drug Medicare Standardized Payment Amount | 1338.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 146 |
| Number Of Medical Services | 3080 |
| Number Of Medicare Beneficiaries With Medical Services | 1921 |
| Total Medical Submitted Charge Amount | 712965 |
| Total Medical Medicare Allowed Amount | 135991.52 |
| Total Medical Medicare Payment Amount | 102547.28 |
| Total Medical Medicare Standardized Payment Amount | 105854.23 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 572 |
| Number Of Beneficiaries Age 65 to 74 | 672 |
| Number Of Beneficiaries Age 75 to 84 | 447 |
| Number Of Beneficiaries Age Greater 84 | 230 |
| Number Of Female Beneficiaries | 1107 |
| Number Of Male Beneficiaries | 814 |
| Number Of Non Hispanic White Beneficiaries | 761 |
| Number Of Black or African American Beneficiaries | 852 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 272 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1124 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 797 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.6864 |