| National Provider Identifier [NPI]: | 1073569729 |
| Last Name Of The Provider | NGUYEN |
| First Name Of The Provider | VU |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 121 S SAINT LOUIS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH BEND |
| Zip Code Of The Provider | 466172924 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 166 |
| Number Of Services | 5396 |
| Number Of Medicare Beneficiaries | 2903 |
| Total Submitted Charge Amount | 585201.1 |
| Total Medicare Allowed Amount | 174245.7 |
| Total Medicare Payment Amount | 132949.76 |
| Total Medicare Standardized Payment Amount | 140507.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 900 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 2497.86 |
| Total Drug Medicare AllowedAmount | 2437.67 |
| Total Drug Medicare PaymentAmount | 1901.62 |
| Total Drug Medicare Standardized Payment Amount | 1901.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 160 |
| Number Of Medical Services | 4496 |
| Number Of Medicare Beneficiaries With Medical Services | 2903 |
| Total Medical Submitted Charge Amount | 582703.24 |
| Total Medical Medicare Allowed Amount | 171808.03 |
| Total Medical Medicare Payment Amount | 131048.14 |
| Total Medical Medicare Standardized Payment Amount | 138606.36 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 507 |
| Number Of Beneficiaries Age 65 to 74 | 1039 |
| Number Of Beneficiaries Age 75 to 84 | 821 |
| Number Of Beneficiaries Age Greater 84 | 536 |
| Number Of Female Beneficiaries | 1723 |
| Number Of Male Beneficiaries | 1180 |
| Number Of Non Hispanic White Beneficiaries | 2614 |
| Number Of Black or African American Beneficiaries | 203 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2223 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 680 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7011 |