National Provider Identifier [NPI]: |
1598939175 |
Last Name Of The Provider |
NGUYEN |
First Name Of The Provider |
TONY |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
18444 N 25TH AVE |
Street Address 2 Of The Provider |
STE 210 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850231264 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
539 |
Number Of Medicare Beneficiaries |
143 |
Total Submitted Charge Amount |
181480.79 |
Total Medicare Allowed Amount |
66427.19 |
Total Medicare Payment Amount |
50836.6 |
Total Medicare Standardized Payment Amount |
50816.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
144 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
12697.22 |
Total Drug Medicare AllowedAmount |
4764.83 |
Total Drug Medicare PaymentAmount |
3610.44 |
Total Drug Medicare Standardized Payment Amount |
3610.44 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
57 |
Number Of Medical Services |
395 |
Number Of Medicare Beneficiaries With Medical Services |
143 |
Total Medical Submitted Charge Amount |
168783.57 |
Total Medical Medicare Allowed Amount |
61662.36 |
Total Medical Medicare Payment Amount |
47226.16 |
Total Medical Medicare Standardized Payment Amount |
47205.86 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
39 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
118 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
105 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6359 |