National Provider Identifier [NPI]: |
1073500039 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
HARRY |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2715 SAWBURY BLVD. |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
43235 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Addiction Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
999 |
Number Of Medicare Beneficiaries |
318 |
Total Submitted Charge Amount |
180671 |
Total Medicare Allowed Amount |
86688.9 |
Total Medicare Payment Amount |
65416.78 |
Total Medicare Standardized Payment Amount |
67215.18 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
51 |
Number Of Beneficiaries Age Less65 |
244 |
Number Of Beneficiaries Age 65 to 74 |
54 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
140 |
Number Of Male Beneficiaries |
178 |
Number Of Non Hispanic White Beneficiaries |
259 |
Number Of Black or African American Beneficiaries |
45 |
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 |
124 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
194 |
Percent Of With Atrial Fibrillation |
3 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
63 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
29 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3541 |