National Provider Identifier [NPI]: |
1811956006 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
LONG |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3300 NW EXPRESSWAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731124418 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
1998 |
Number Of Medicare Beneficiaries |
574 |
Total Submitted Charge Amount |
160338.87 |
Total Medicare Allowed Amount |
156248.15 |
Total Medicare Payment Amount |
120560.77 |
Total Medicare Standardized Payment Amount |
128676.87 |
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 |
20 |
Number Of Medical Services |
1998 |
Number Of Medicare Beneficiaries With Medical Services |
574 |
Total Medical Submitted Charge Amount |
160338.87 |
Total Medical Medicare Allowed Amount |
156248.15 |
Total Medical Medicare Payment Amount |
120560.77 |
Total Medical Medicare Standardized Payment Amount |
128676.87 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
154 |
Number Of Beneficiaries Age 75 to 84 |
167 |
Number Of Beneficiaries Age Greater 84 |
132 |
Number Of Female Beneficiaries |
357 |
Number Of Male Beneficiaries |
217 |
Number Of Non Hispanic White Beneficiaries |
468 |
Number Of Black or African American Beneficiaries |
57 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
29 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
345 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
229 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
40 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
48 |
Percent Of With Depression |
56 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
61 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.3355 |