National Provider Identifier [NPI]: |
1265759823 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
ANH |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3600 GASTON AVE |
Street Address 2 Of The Provider |
SUITE 4 ROBERTS |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752461800 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
1102 |
Number Of Medicare Beneficiaries |
398 |
Total Submitted Charge Amount |
188119 |
Total Medicare Allowed Amount |
112036.13 |
Total Medicare Payment Amount |
86042.93 |
Total Medicare Standardized Payment Amount |
87004.58 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
1102 |
Number Of Medicare Beneficiaries With Medical Services |
398 |
Total Medical Submitted Charge Amount |
188119 |
Total Medical Medicare Allowed Amount |
112036.13 |
Total Medical Medicare Payment Amount |
86042.93 |
Total Medical Medicare Standardized Payment Amount |
87004.58 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
126 |
Number Of Beneficiaries Age 75 to 84 |
136 |
Number Of Beneficiaries Age Greater 84 |
79 |
Number Of Female Beneficiaries |
242 |
Number Of Male Beneficiaries |
156 |
Number Of Non Hispanic White Beneficiaries |
292 |
Number Of Black or African American Beneficiaries |
85 |
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 |
318 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.32 |