| National Provider Identifier [NPI]: | 1700089935 |
| Last Name Of The Provider | PHAM |
| First Name Of The Provider | VICTORIA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17195 NEWHOPE ST STE 107 |
| Street Address 2 Of The Provider | |
| City Of The Provider | FOUNTAIN VALLEY |
| Zip Code Of The Provider | 927084211 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 2444 |
| Number Of Medicare Beneficiaries | 436 |
| Total Submitted Charge Amount | 508732 |
| Total Medicare Allowed Amount | 287471.14 |
| Total Medicare Payment Amount | 219438.35 |
| Total Medicare Standardized Payment Amount | 201945.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 160 |
| Number Of Medicare Beneficiaries With Drug Services | 160 |
| Total Drug Submitted ChargeAmount | 4800 |
| Total Drug Medicare AllowedAmount | 2463.12 |
| Total Drug Medicare PaymentAmount | 2413.54 |
| Total Drug Medicare Standardized Payment Amount | 2413.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 2284 |
| Number Of Medicare Beneficiaries With Medical Services | 436 |
| Total Medical Submitted Charge Amount | 503932 |
| Total Medical Medicare Allowed Amount | 285008.02 |
| Total Medical Medicare Payment Amount | 217024.81 |
| Total Medical Medicare Standardized Payment Amount | 199531.52 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 66 |
| Number Of Beneficiaries Age 75 to 84 | 134 |
| Number Of Beneficiaries Age Greater 84 | 200 |
| Number Of Female Beneficiaries | 273 |
| Number Of Male Beneficiaries | 163 |
| Number Of Non Hispanic White Beneficiaries | 111 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 294 |
| 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 | 86 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 350 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 67 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 24 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.2918 |