| National Provider Identifier [NPI]: | 1992901250 |
| Last Name Of The Provider | NGUYEN |
| First Name Of The Provider | CHANH |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 751 S BASCOM AVE |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY |
| City Of The Provider | SAN JOSE |
| Zip Code Of The Provider | 951282604 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 326 |
| Number Of Services | 9469 |
| Number Of Medicare Beneficiaries | 3552 |
| Total Submitted Charge Amount | 2821062.2 |
| Total Medicare Allowed Amount | 601521.88 |
| Total Medicare Payment Amount | 466097.44 |
| Total Medicare Standardized Payment Amount | 451127.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 2564 |
| Number Of Medicare Beneficiaries With Drug Services | 130 |
| Total Drug Submitted ChargeAmount | 5478 |
| Total Drug Medicare AllowedAmount | 1029.78 |
| Total Drug Medicare PaymentAmount | 791.26 |
| Total Drug Medicare Standardized Payment Amount | 791.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 309 |
| Number Of Medical Services | 6905 |
| Number Of Medicare Beneficiaries With Medical Services | 3552 |
| Total Medical Submitted Charge Amount | 2815584.2 |
| Total Medical Medicare Allowed Amount | 600492.1 |
| Total Medical Medicare Payment Amount | 465306.18 |
| Total Medical Medicare Standardized Payment Amount | 450336.01 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 667 |
| Number Of Beneficiaries Age 65 to 74 | 1203 |
| Number Of Beneficiaries Age 75 to 84 | 1016 |
| Number Of Beneficiaries Age Greater 84 | 666 |
| Number Of Female Beneficiaries | 1874 |
| Number Of Male Beneficiaries | 1678 |
| Number Of Non Hispanic White Beneficiaries | 2099 |
| Number Of Black or African American Beneficiaries | 215 |
| Number Of AsianPacific Islander Beneficiaries | 265 |
| Number Of Hispanic Beneficiaries | 895 |
| Number Of American Indian Alaska Native Beneficiaries | 35 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1907 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1645 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.3217 |