National Provider Identifier [NPI]: |
1356339717 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
409 MADRID ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CASTROVILLE |
Zip Code Of The Provider |
780094527 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
653 |
Number Of Medicare Beneficiaries |
116 |
Total Submitted Charge Amount |
49475.38 |
Total Medicare Allowed Amount |
43857.78 |
Total Medicare Payment Amount |
29777.05 |
Total Medicare Standardized Payment Amount |
33413.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
31 |
Number Of Medicare Beneficiaries With Drug Services |
30 |
Total Drug Submitted ChargeAmount |
921.44 |
Total Drug Medicare AllowedAmount |
915.54 |
Total Drug Medicare PaymentAmount |
892.72 |
Total Drug Medicare Standardized Payment Amount |
892.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
622 |
Number Of Medicare Beneficiaries With Medical Services |
116 |
Total Medical Submitted Charge Amount |
48553.94 |
Total Medical Medicare Allowed Amount |
42942.24 |
Total Medical Medicare Payment Amount |
28884.33 |
Total Medical Medicare Standardized Payment Amount |
32520.72 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
23 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
37 |
Number Of Non Hispanic White Beneficiaries |
95 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
92 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
28 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8728 |