National Provider Identifier [NPI]: |
1790954931 |
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 |
1 WASHINGTON SQ |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW BRITAIN |
Zip Code Of The Provider |
060511848 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1464 |
Number Of Medicare Beneficiaries |
437 |
Total Submitted Charge Amount |
359168 |
Total Medicare Allowed Amount |
160888.66 |
Total Medicare Payment Amount |
125819.14 |
Total Medicare Standardized Payment Amount |
119252.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
1464 |
Number Of Medicare Beneficiaries With Medical Services |
437 |
Total Medical Submitted Charge Amount |
359168 |
Total Medical Medicare Allowed Amount |
160888.66 |
Total Medical Medicare Payment Amount |
125819.14 |
Total Medical Medicare Standardized Payment Amount |
119252.62 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
162 |
Number Of Female Beneficiaries |
254 |
Number Of Male Beneficiaries |
183 |
Number Of Non Hispanic White Beneficiaries |
395 |
Number Of Black or African American Beneficiaries |
16 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
254 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
183 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
34 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
21 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.3956 |