National Provider Identifier [NPI]: |
1396779831 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
VAN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2020 PALOMINO LN STE 100 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891064894 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
185 |
Number Of Services |
12459 |
Number Of Medicare Beneficiaries |
3218 |
Total Submitted Charge Amount |
1207527.95 |
Total Medicare Allowed Amount |
239115.53 |
Total Medicare Payment Amount |
181849.34 |
Total Medicare Standardized Payment Amount |
179251.02 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
8115 |
Number Of Medicare Beneficiaries With Drug Services |
105 |
Total Drug Submitted ChargeAmount |
18540.96 |
Total Drug Medicare AllowedAmount |
2926.07 |
Total Drug Medicare PaymentAmount |
2294.03 |
Total Drug Medicare Standardized Payment Amount |
2294.03 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
179 |
Number Of Medical Services |
4344 |
Number Of Medicare Beneficiaries With Medical Services |
3218 |
Total Medical Submitted Charge Amount |
1188986.99 |
Total Medical Medicare Allowed Amount |
236189.46 |
Total Medical Medicare Payment Amount |
179555.31 |
Total Medical Medicare Standardized Payment Amount |
176956.99 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
802 |
Number Of Beneficiaries Age 65 to 74 |
1230 |
Number Of Beneficiaries Age 75 to 84 |
842 |
Number Of Beneficiaries Age Greater 84 |
344 |
Number Of Female Beneficiaries |
1844 |
Number Of Male Beneficiaries |
1374 |
Number Of Non Hispanic White Beneficiaries |
2281 |
Number Of Black or African American Beneficiaries |
415 |
Number Of AsianPacific Islander Beneficiaries |
141 |
Number Of Hispanic Beneficiaries |
319 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
2292 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
926 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
1.9599 |