National Provider Identifier [NPI]: |
1255379442 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
TRI |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
20414 N 27TH AVE |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850273250 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
6485 |
Number Of Medicare Beneficiaries |
1229 |
Total Submitted Charge Amount |
1446620 |
Total Medicare Allowed Amount |
733602.44 |
Total Medicare Payment Amount |
548547.41 |
Total Medicare Standardized Payment Amount |
561848.05 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
601 |
Number Of Medicare Beneficiaries With Drug Services |
187 |
Total Drug Submitted ChargeAmount |
75330 |
Total Drug Medicare AllowedAmount |
30564.58 |
Total Drug Medicare PaymentAmount |
23592.54 |
Total Drug Medicare Standardized Payment Amount |
23592.54 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
75 |
Number Of Medical Services |
5884 |
Number Of Medicare Beneficiaries With Medical Services |
1229 |
Total Medical Submitted Charge Amount |
1371290 |
Total Medical Medicare Allowed Amount |
703037.86 |
Total Medical Medicare Payment Amount |
524954.87 |
Total Medical Medicare Standardized Payment Amount |
538255.51 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
136 |
Number Of Beneficiaries Age 65 to 74 |
633 |
Number Of Beneficiaries Age 75 to 84 |
311 |
Number Of Beneficiaries Age Greater 84 |
149 |
Number Of Female Beneficiaries |
614 |
Number Of Male Beneficiaries |
615 |
Number Of Non Hispanic White Beneficiaries |
1077 |
Number Of Black or African American Beneficiaries |
41 |
Number Of AsianPacific Islander Beneficiaries |
32 |
Number Of Hispanic Beneficiaries |
59 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1059 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
170 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.5763 |