National Provider Identifier [NPI]: |
1780842146 |
Last Name Of The Provider |
DUONG |
First Name Of The Provider |
CHUONG |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5201 HARRY HINES BLVD. |
Street Address 2 Of The Provider |
ATTN: URGENT CARE |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
75235 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
524 |
Number Of Medicare Beneficiaries |
449 |
Total Submitted Charge Amount |
441883 |
Total Medicare Allowed Amount |
69781.67 |
Total Medicare Payment Amount |
52690.07 |
Total Medicare Standardized Payment Amount |
52867.88 |
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 |
19 |
Number Of Medical Services |
524 |
Number Of Medicare Beneficiaries With Medical Services |
449 |
Total Medical Submitted Charge Amount |
441883 |
Total Medical Medicare Allowed Amount |
69781.67 |
Total Medical Medicare Payment Amount |
52690.07 |
Total Medical Medicare Standardized Payment Amount |
52867.88 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
181 |
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
99 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
245 |
Number Of Male Beneficiaries |
204 |
Number Of Non Hispanic White Beneficiaries |
137 |
Number Of Black or African American Beneficiaries |
252 |
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 |
195 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
254 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.7186 |