National Provider Identifier [NPI]: |
1750382008 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
RANDALL |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4300 LONG BEACH BLVD |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
LONG BEACH |
Zip Code Of The Provider |
908072011 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
12609.5 |
Number Of Medicare Beneficiaries |
842 |
Total Submitted Charge Amount |
2694080.5 |
Total Medicare Allowed Amount |
1518598.12 |
Total Medicare Payment Amount |
1157750.68 |
Total Medicare Standardized Payment Amount |
1086140.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
1283.5 |
Number Of Medicare Beneficiaries With Drug Services |
146 |
Total Drug Submitted ChargeAmount |
1209467.5 |
Total Drug Medicare AllowedAmount |
571048.42 |
Total Drug Medicare PaymentAmount |
447505.83 |
Total Drug Medicare Standardized Payment Amount |
447505.83 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
39 |
Number Of Medical Services |
11326 |
Number Of Medicare Beneficiaries With Medical Services |
842 |
Total Medical Submitted Charge Amount |
1484613 |
Total Medical Medicare Allowed Amount |
947549.7 |
Total Medical Medicare Payment Amount |
710244.85 |
Total Medical Medicare Standardized Payment Amount |
638634.18 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
297 |
Number Of Beneficiaries Age 75 to 84 |
320 |
Number Of Beneficiaries Age Greater 84 |
183 |
Number Of Female Beneficiaries |
461 |
Number Of Male Beneficiaries |
381 |
Number Of Non Hispanic White Beneficiaries |
447 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
315 |
Number Of Hispanic Beneficiaries |
47 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
527 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
315 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4847 |