National Provider Identifier [NPI]: |
1750483590 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
CHRISTINE |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
910 SYCAMORE AVE |
Street Address 2 Of The Provider |
270 |
City Of The Provider |
VISTA |
Zip Code Of The Provider |
920817832 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
1441 |
Number Of Medicare Beneficiaries |
274 |
Total Submitted Charge Amount |
154086.5 |
Total Medicare Allowed Amount |
87384.08 |
Total Medicare Payment Amount |
64978.21 |
Total Medicare Standardized Payment Amount |
62966.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
55.5 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
2677.5 |
Total Drug Medicare AllowedAmount |
1406.04 |
Total Drug Medicare PaymentAmount |
1364.19 |
Total Drug Medicare Standardized Payment Amount |
1364.19 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
66 |
Number Of Medical Services |
1385.5 |
Number Of Medicare Beneficiaries With Medical Services |
274 |
Total Medical Submitted Charge Amount |
151409 |
Total Medical Medicare Allowed Amount |
85978.04 |
Total Medical Medicare Payment Amount |
63614.02 |
Total Medical Medicare Standardized Payment Amount |
61602.12 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
66 |
Number Of Female Beneficiaries |
172 |
Number Of Male Beneficiaries |
102 |
Number Of Non Hispanic White Beneficiaries |
227 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
235 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1996 |