| National Provider Identifier [NPI]: | 1578526448 |
| Last Name Of The Provider | HOANG |
| First Name Of The Provider | MINH |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 INGALLS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | HARVEY |
| Zip Code Of The Provider | 604263558 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 174 |
| Number Of Services | 5450 |
| Number Of Medicare Beneficiaries | 3382 |
| Total Submitted Charge Amount | 1220495 |
| Total Medicare Allowed Amount | 198418.16 |
| Total Medicare Payment Amount | 157242.7 |
| Total Medicare Standardized Payment Amount | 147591.08 |
| 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 | 174 |
| Number Of Medical Services | 5450 |
| Number Of Medicare Beneficiaries With Medical Services | 3382 |
| Total Medical Submitted Charge Amount | 1220495 |
| Total Medical Medicare Allowed Amount | 198418.16 |
| Total Medical Medicare Payment Amount | 157242.7 |
| Total Medical Medicare Standardized Payment Amount | 147591.08 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 640 |
| Number Of Beneficiaries Age 65 to 74 | 1350 |
| Number Of Beneficiaries Age 75 to 84 | 963 |
| Number Of Beneficiaries Age Greater 84 | 429 |
| Number Of Female Beneficiaries | 2358 |
| Number Of Male Beneficiaries | 1024 |
| Number Of Non Hispanic White Beneficiaries | 1573 |
| Number Of Black or African American Beneficiaries | 1647 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 117 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2358 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1024 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7415 |