National Provider Identifier [NPI]: |
1861655284 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30 NORTH 1900 EAST #1A071 |
Street Address 2 Of The Provider |
DEPARTMENT OF RADIOLOGY |
City Of The Provider |
SALT LAKE CITY |
Zip Code Of The Provider |
841322140 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
203 |
Number Of Services |
4842 |
Number Of Medicare Beneficiaries |
2948 |
Total Submitted Charge Amount |
480355.83 |
Total Medicare Allowed Amount |
164301.65 |
Total Medicare Payment Amount |
121803.92 |
Total Medicare Standardized Payment Amount |
125798.92 |
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 |
203 |
Number Of Medical Services |
4842 |
Number Of Medicare Beneficiaries With Medical Services |
2948 |
Total Medical Submitted Charge Amount |
480355.83 |
Total Medical Medicare Allowed Amount |
164301.65 |
Total Medical Medicare Payment Amount |
121803.92 |
Total Medical Medicare Standardized Payment Amount |
125798.92 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
489 |
Number Of Beneficiaries Age 65 to 74 |
1047 |
Number Of Beneficiaries Age 75 to 84 |
930 |
Number Of Beneficiaries Age Greater 84 |
482 |
Number Of Female Beneficiaries |
1600 |
Number Of Male Beneficiaries |
1348 |
Number Of Non Hispanic White Beneficiaries |
2568 |
Number Of Black or African American Beneficiaries |
41 |
Number Of AsianPacific Islander Beneficiaries |
43 |
Number Of Hispanic Beneficiaries |
241 |
Number Of American Indian Alaska Native Beneficiaries |
22 |
Number Of Beneficiaries With Race Not Else where Classified |
33 |
Number Of Beneficiaries With Medicare Only Entitlement |
2278 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
670 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.6518 |