National Provider Identifier [NPI]: |
1164621314 |
Last Name Of The Provider |
VU |
First Name Of The Provider |
HOANG |
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 |
440 SW PERIMETER GLN |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKE CITY |
Zip Code Of The Provider |
320250497 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
26505 |
Number Of Medicare Beneficiaries |
1259 |
Total Submitted Charge Amount |
2062667.55 |
Total Medicare Allowed Amount |
796106.38 |
Total Medicare Payment Amount |
642160.52 |
Total Medicare Standardized Payment Amount |
613305.58 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
6699 |
Number Of Medicare Beneficiaries With Drug Services |
416 |
Total Drug Submitted ChargeAmount |
57267.66 |
Total Drug Medicare AllowedAmount |
14258.24 |
Total Drug Medicare PaymentAmount |
10975.7 |
Total Drug Medicare Standardized Payment Amount |
10975.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
19806 |
Number Of Medicare Beneficiaries With Medical Services |
1259 |
Total Medical Submitted Charge Amount |
2005399.89 |
Total Medical Medicare Allowed Amount |
781848.14 |
Total Medical Medicare Payment Amount |
631184.82 |
Total Medical Medicare Standardized Payment Amount |
602329.88 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
539 |
Number Of Beneficiaries Age 65 to 74 |
426 |
Number Of Beneficiaries Age 75 to 84 |
220 |
Number Of Beneficiaries Age Greater 84 |
74 |
Number Of Female Beneficiaries |
813 |
Number Of Male Beneficiaries |
446 |
Number Of Non Hispanic White Beneficiaries |
1089 |
Number Of Black or African American Beneficiaries |
126 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
680 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
579 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5263 |