| National Provider Identifier [NPI]: | 1821082421 |
| Last Name Of The Provider | NGUYEN |
| First Name Of The Provider | KHOA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1499 FAIR ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | STATESBORO |
| Zip Code Of The Provider | 30458 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 230 |
| Number Of Services | 6514 |
| Number Of Medicare Beneficiaries | 3057 |
| Total Submitted Charge Amount | 1205257 |
| Total Medicare Allowed Amount | 233509.95 |
| Total Medicare Payment Amount | 178398.88 |
| Total Medicare Standardized Payment Amount | 186452.28 |
| 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 | 230 |
| Number Of Medical Services | 6514 |
| Number Of Medicare Beneficiaries With Medical Services | 3057 |
| Total Medical Submitted Charge Amount | 1205257 |
| Total Medical Medicare Allowed Amount | 233509.95 |
| Total Medical Medicare Payment Amount | 178398.88 |
| Total Medical Medicare Standardized Payment Amount | 186452.28 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 718 |
| Number Of Beneficiaries Age 65 to 74 | 1186 |
| Number Of Beneficiaries Age 75 to 84 | 819 |
| Number Of Beneficiaries Age Greater 84 | 334 |
| Number Of Female Beneficiaries | 1914 |
| Number Of Male Beneficiaries | 1143 |
| Number Of Non Hispanic White Beneficiaries | 2275 |
| Number Of Black or African American Beneficiaries | 723 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1957 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1100 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6322 |