National Provider Identifier [NPI]: |
1083690929 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
THANH |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3105 LIMESTONE RD |
Street Address 2 Of The Provider |
SUITE 106 |
City Of The Provider |
WILMINGTON |
Zip Code Of The Provider |
198082147 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
140 |
Number Of Services |
12233 |
Number Of Medicare Beneficiaries |
1805 |
Total Submitted Charge Amount |
1103910 |
Total Medicare Allowed Amount |
310111.97 |
Total Medicare Payment Amount |
244438.07 |
Total Medicare Standardized Payment Amount |
239376.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
9098 |
Number Of Medicare Beneficiaries With Drug Services |
121 |
Total Drug Submitted ChargeAmount |
13211 |
Total Drug Medicare AllowedAmount |
2761.87 |
Total Drug Medicare PaymentAmount |
2139.94 |
Total Drug Medicare Standardized Payment Amount |
2139.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
138 |
Number Of Medical Services |
3135 |
Number Of Medicare Beneficiaries With Medical Services |
1805 |
Total Medical Submitted Charge Amount |
1090699 |
Total Medical Medicare Allowed Amount |
307350.1 |
Total Medical Medicare Payment Amount |
242298.13 |
Total Medical Medicare Standardized Payment Amount |
237237.03 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
158 |
Number Of Beneficiaries Age 65 to 74 |
915 |
Number Of Beneficiaries Age 75 to 84 |
530 |
Number Of Beneficiaries Age Greater 84 |
202 |
Number Of Female Beneficiaries |
1317 |
Number Of Male Beneficiaries |
488 |
Number Of Non Hispanic White Beneficiaries |
1516 |
Number Of Black or African American Beneficiaries |
172 |
Number Of AsianPacific Islander Beneficiaries |
60 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
29 |
Number Of Beneficiaries With Medicare Only Entitlement |
1654 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
151 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9704 |