National Provider Identifier [NPI]: |
1023057700 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
DUNG |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7340 E SPEEDWAY BLVD |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857101352 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
163 |
Number Of Services |
6757 |
Number Of Medicare Beneficiaries |
261 |
Total Submitted Charge Amount |
459943 |
Total Medicare Allowed Amount |
243022.18 |
Total Medicare Payment Amount |
191292.32 |
Total Medicare Standardized Payment Amount |
195865.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
873 |
Number Of Medicare Beneficiaries With Drug Services |
137 |
Total Drug Submitted ChargeAmount |
28603 |
Total Drug Medicare AllowedAmount |
18502.67 |
Total Drug Medicare PaymentAmount |
17938.57 |
Total Drug Medicare Standardized Payment Amount |
17938.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
152 |
Number Of Medical Services |
5884 |
Number Of Medicare Beneficiaries With Medical Services |
261 |
Total Medical Submitted Charge Amount |
431340 |
Total Medical Medicare Allowed Amount |
224519.51 |
Total Medical Medicare Payment Amount |
173353.75 |
Total Medical Medicare Standardized Payment Amount |
177927.04 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
77 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
148 |
Number Of Male Beneficiaries |
113 |
Number Of Non Hispanic White Beneficiaries |
152 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
63 |
Number Of Hispanic Beneficiaries |
31 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
176 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9933 |