National Provider Identifier [NPI]: |
1366400145 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
QUY |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9126 VALLEY BLVD |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
ROSEMEAD |
Zip Code Of The Provider |
917701987 |
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 |
18 |
Number Of Services |
1445 |
Number Of Medicare Beneficiaries |
304 |
Total Submitted Charge Amount |
126827 |
Total Medicare Allowed Amount |
77235.71 |
Total Medicare Payment Amount |
53158.1 |
Total Medicare Standardized Payment Amount |
49109.58 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
196 |
Number Of Medicare Beneficiaries With Drug Services |
157 |
Total Drug Submitted ChargeAmount |
13535 |
Total Drug Medicare AllowedAmount |
8117.65 |
Total Drug Medicare PaymentAmount |
7954.82 |
Total Drug Medicare Standardized Payment Amount |
7954.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
1249 |
Number Of Medicare Beneficiaries With Medical Services |
304 |
Total Medical Submitted Charge Amount |
113292 |
Total Medical Medicare Allowed Amount |
69118.06 |
Total Medical Medicare Payment Amount |
45203.28 |
Total Medical Medicare Standardized Payment Amount |
41154.76 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
158 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
174 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
17 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
287 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
5 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1144 |