National Provider Identifier [NPI]: |
1114119526 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
SON |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1525 WEBSTER ST |
Street Address 2 Of The Provider |
A |
City Of The Provider |
FAIRFIELD |
Zip Code Of The Provider |
945334997 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
1625 |
Number Of Medicare Beneficiaries |
539 |
Total Submitted Charge Amount |
323008 |
Total Medicare Allowed Amount |
173568.06 |
Total Medicare Payment Amount |
132766.79 |
Total Medicare Standardized Payment Amount |
122092.7 |
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 |
1625 |
Number Of Medicare Beneficiaries With Medical Services |
539 |
Total Medical Submitted Charge Amount |
323008 |
Total Medical Medicare Allowed Amount |
173568.06 |
Total Medical Medicare Payment Amount |
132766.79 |
Total Medical Medicare Standardized Payment Amount |
122092.7 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
137 |
Number Of Beneficiaries Age 75 to 84 |
164 |
Number Of Beneficiaries Age Greater 84 |
188 |
Number Of Female Beneficiaries |
302 |
Number Of Male Beneficiaries |
237 |
Number Of Non Hispanic White Beneficiaries |
455 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
22 |
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
406 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
133 |
Percent Of With Atrial Fibrillation |
33 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
1.9735 |