| National Provider Identifier [NPI]: | 1811273600 |
| Last Name Of The Provider | PHAM |
| First Name Of The Provider | MAIKHOI |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | DPM, MBA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2291 SE FEDERAL HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | STUART |
| Zip Code Of The Provider | 349944516 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 2476 |
| Number Of Medicare Beneficiaries | 585 |
| Total Submitted Charge Amount | 664852 |
| Total Medicare Allowed Amount | 191882.09 |
| Total Medicare Payment Amount | 148467.86 |
| Total Medicare Standardized Payment Amount | 139588.63 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 114 |
| Number Of Beneficiaries Age 75 to 84 | 185 |
| Number Of Beneficiaries Age Greater 84 | 220 |
| Number Of Female Beneficiaries | 320 |
| Number Of Male Beneficiaries | 265 |
| Number Of Non Hispanic White Beneficiaries | 519 |
| Number Of Black or African American Beneficiaries | 33 |
| 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 | 425 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 160 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 38 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.2874 |