National Provider Identifier [NPI]: |
1457414245 |
Last Name Of The Provider |
DUONG |
First Name Of The Provider |
BICH |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
724 MAIDEN CHOICE LANE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BALTIMORE |
Zip Code Of The Provider |
21228 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
916 |
Number Of Medicare Beneficiaries |
201 |
Total Submitted Charge Amount |
79260 |
Total Medicare Allowed Amount |
75527.06 |
Total Medicare Payment Amount |
51333.08 |
Total Medicare Standardized Payment Amount |
51568.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
91 |
Number Of Medicare Beneficiaries With Drug Services |
89 |
Total Drug Submitted ChargeAmount |
2730 |
Total Drug Medicare AllowedAmount |
780.78 |
Total Drug Medicare PaymentAmount |
765.31 |
Total Drug Medicare Standardized Payment Amount |
765.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
9 |
Number Of Medical Services |
825 |
Number Of Medicare Beneficiaries With Medical Services |
201 |
Total Medical Submitted Charge Amount |
76530 |
Total Medical Medicare Allowed Amount |
74746.28 |
Total Medical Medicare Payment Amount |
50567.77 |
Total Medical Medicare Standardized Payment Amount |
50803.6 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
18 |
Number Of Female Beneficiaries |
108 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
90 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
64 |
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 |
117 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9855 |