National Provider Identifier [NPI]: |
1528054095 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
DEREK |
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 |
4445 MAGNOLIA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
RIVERSIDE |
Zip Code Of The Provider |
925014135 |
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 |
81 |
Number Of Services |
4910 |
Number Of Medicare Beneficiaries |
796 |
Total Submitted Charge Amount |
997681.8 |
Total Medicare Allowed Amount |
540512.69 |
Total Medicare Payment Amount |
411158.71 |
Total Medicare Standardized Payment Amount |
401063.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
100 |
Number Of Medicare Beneficiaries With Drug Services |
66 |
Total Drug Submitted ChargeAmount |
3452.8 |
Total Drug Medicare AllowedAmount |
1113.86 |
Total Drug Medicare PaymentAmount |
1082.94 |
Total Drug Medicare Standardized Payment Amount |
1082.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
71 |
Number Of Medical Services |
4810 |
Number Of Medicare Beneficiaries With Medical Services |
796 |
Total Medical Submitted Charge Amount |
994229 |
Total Medical Medicare Allowed Amount |
539398.83 |
Total Medical Medicare Payment Amount |
410075.77 |
Total Medical Medicare Standardized Payment Amount |
399980.54 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
104 |
Number Of Beneficiaries Age 65 to 74 |
229 |
Number Of Beneficiaries Age 75 to 84 |
282 |
Number Of Beneficiaries Age Greater 84 |
181 |
Number Of Female Beneficiaries |
476 |
Number Of Male Beneficiaries |
320 |
Number Of Non Hispanic White Beneficiaries |
488 |
Number Of Black or African American Beneficiaries |
66 |
Number Of AsianPacific Islander Beneficiaries |
53 |
Number Of Hispanic Beneficiaries |
175 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
449 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
347 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.2106 |