| National Provider Identifier [NPI]: | 1235310004 |
| Last Name Of The Provider | SOM |
| First Name Of The Provider | HANH-DUNG |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1230 E. MAIN STREET |
| Street Address 2 Of The Provider | MANKATO CLINIC @ MAIN STREET |
| City Of The Provider | MANKATO |
| Zip Code Of The Provider | 560028674 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 1281 |
| Number Of Medicare Beneficiaries | 156 |
| Total Submitted Charge Amount | 124964.38 |
| Total Medicare Allowed Amount | 46563.36 |
| Total Medicare Payment Amount | 35477.6 |
| Total Medicare Standardized Payment Amount | 36117.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 90 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 2406.48 |
| Total Drug Medicare AllowedAmount | 1029.49 |
| Total Drug Medicare PaymentAmount | 968.47 |
| Total Drug Medicare Standardized Payment Amount | 968.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 1191 |
| Number Of Medicare Beneficiaries With Medical Services | 156 |
| Total Medical Submitted Charge Amount | 122557.9 |
| Total Medical Medicare Allowed Amount | 45533.87 |
| Total Medical Medicare Payment Amount | 34509.13 |
| Total Medical Medicare Standardized Payment Amount | 35149.51 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 40 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 124 |
| Number Of Male Beneficiaries | 32 |
| Number Of Non Hispanic White Beneficiaries | 144 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 99 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2078 |