| National Provider Identifier [NPI]: | 1831247667 |
| Last Name Of The Provider | PHAN |
| First Name Of The Provider | VU |
| Middle Initial Of The Provider | Q |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3851 KATELLA AVE |
| Street Address 2 Of The Provider | SUITE 125 |
| City Of The Provider | LOS ALAMITOS |
| Zip Code Of The Provider | 907203309 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 107739 |
| Number Of Medicare Beneficiaries | 456 |
| Total Submitted Charge Amount | 2749773.5 |
| Total Medicare Allowed Amount | 1122758.74 |
| Total Medicare Payment Amount | 872925.94 |
| Total Medicare Standardized Payment Amount | 829800.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 54 |
| Number Of Drug Services | 102948 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 1981471 |
| Total Drug Medicare AllowedAmount | 698165.11 |
| Total Drug Medicare PaymentAmount | 546566.99 |
| Total Drug Medicare Standardized Payment Amount | 546566.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 4791 |
| Number Of Medicare Beneficiaries With Medical Services | 456 |
| Total Medical Submitted Charge Amount | 768302.5 |
| Total Medical Medicare Allowed Amount | 424593.63 |
| Total Medical Medicare Payment Amount | 326358.95 |
| Total Medical Medicare Standardized Payment Amount | 283233.13 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 162 |
| Number Of Beneficiaries Age 75 to 84 | 136 |
| Number Of Beneficiaries Age Greater 84 | 104 |
| Number Of Female Beneficiaries | 248 |
| Number Of Male Beneficiaries | 208 |
| Number Of Non Hispanic White Beneficiaries | 249 |
| Number Of Black or African American Beneficiaries | 53 |
| Number Of AsianPacific Islander Beneficiaries | 76 |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 234 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 222 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 35 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.4705 |