| National Provider Identifier [NPI]: | 1982698528 |
| Last Name Of The Provider | NGUYEN |
| First Name Of The Provider | DAT |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1739 E BEVERLY AVE |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | KINGMAN |
| Zip Code Of The Provider | 864093593 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Critical Care (Intensivists) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 2889 |
| Number Of Medicare Beneficiaries | 923 |
| Total Submitted Charge Amount | 700110 |
| Total Medicare Allowed Amount | 237700.35 |
| Total Medicare Payment Amount | 177383.06 |
| Total Medicare Standardized Payment Amount | 180287.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 101 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 1321 |
| Total Drug Medicare AllowedAmount | 633.2 |
| Total Drug Medicare PaymentAmount | 582.32 |
| Total Drug Medicare Standardized Payment Amount | 582.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 2788 |
| Number Of Medicare Beneficiaries With Medical Services | 923 |
| Total Medical Submitted Charge Amount | 698789 |
| Total Medical Medicare Allowed Amount | 237067.15 |
| Total Medical Medicare Payment Amount | 176800.74 |
| Total Medical Medicare Standardized Payment Amount | 179705.35 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 428 |
| Number Of Beneficiaries Age 75 to 84 | 286 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 446 |
| Number Of Male Beneficiaries | 477 |
| Number Of Non Hispanic White Beneficiaries | 868 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 744 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 179 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 65 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.8146 |