National Provider Identifier [NPI]: |
1194889881 |
Last Name Of The Provider |
TRINH |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6165 GRACEMOUNT LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
BEAUMONT |
Zip Code Of The Provider |
777067157 |
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 |
9 |
Number Of Services |
3308 |
Number Of Medicare Beneficiaries |
417 |
Total Submitted Charge Amount |
331865 |
Total Medicare Allowed Amount |
178646.44 |
Total Medicare Payment Amount |
139942.57 |
Total Medicare Standardized Payment Amount |
83296.2 |
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 |
9 |
Number Of Medical Services |
3308 |
Number Of Medicare Beneficiaries With Medical Services |
417 |
Total Medical Submitted Charge Amount |
331865 |
Total Medical Medicare Allowed Amount |
178646.44 |
Total Medical Medicare Payment Amount |
139942.57 |
Total Medical Medicare Standardized Payment Amount |
83296.2 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
133 |
Number Of Beneficiaries Age 75 to 84 |
124 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
225 |
Number Of Male Beneficiaries |
192 |
Number Of Non Hispanic White Beneficiaries |
318 |
Number Of Black or African American Beneficiaries |
86 |
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 |
279 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
138 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
43 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
65 |
Percent Of With Chronic Kidney Disease |
72 |
Percent Of With Chronic Obstructive Pulmonary Disease |
50 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
72 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
2.5399 |