FDFairDoctor.org

Dr. Thomas Nguyen , M.D.

High Markup
Practice Location: Santa Cruz,California 95062
National Provider Identifier (NPI): 1588828719
Procedural
Surgical Specialist
5.41x
Markup Level
71,331
Annual Services
Financial Protection Alert

Higher Out-of-Pocket Billing Risk

This practice submits charges that average 5.4 times customary allowable rates. If you have not met your annual health insurance deductible, or if this doctor is out-of-network with your health plan, you may face significant balance billing.

3 Steps to Protect Your Wallet:
  • Confirm network status: Call your insurer to confirm this specific physician and office address are in-network.
  • Request in-network labs: Before blood draws or biopsies, ask the nurse to send samples exclusively to an in-network commercial laboratory.
  • Ask for a written estimate: Under the No Surprises Act, you are legally entitled to a Good Faith Estimate if you are self-pay or out-of-network.
The Rushed Visit Index

Balanced Practice

Standard Pacing

Maintains a steady clinical rhythm balancing focused physical examination with patient discussion.

How is appointment length calculated?

Visit durations reflect official documentation standards for Evaluation and Management (E/M) office billing codes (CPT 99202 through 99215).

Physicians who bill higher-level comprehensive visits (such as 99214 and 99215) consistently spend 30 to 45 minutes reviewing complex records and discussing care plans, whereas routine refill clinics predominantly bill briefer level 2 and 3 codes.

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Appointment Length & Visit Style

Clinical appointment coding analysis across standard patient evaluations

Consultation Classification
Specialist (Procedures only)

Dr. Nguyen primarily performs clinical procedures, imaging, or laboratory services rather than routine timed office consultations.

What visit duration tells you:
•Thorough evaluations: Longer appointments mean more opportunity to ask questions, review medical histories, and explain treatment options.
•Complex medical care: Patients managing multiple chronic conditions or seeking second opinions often benefit from physicians with extended visit styles.
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Pricing Transparency & Fee Comparison

How this provider bills compared to standard insurance benchmarks

Pricing Markup Ratio
5.41x
National Specialty Average: 2.56x
Total Annual Charges Billed
$4,638,390
Gross billed amount on claims
Standard Benchmark Value
$858,166
Customary fee baseline
Practical Guide for Patients and Families:

⚠️ Price Outlier Warning: Dr. Nguyen's submitted charges are significantly higher than peer medians (over 5.41x the baseline standard). If you receive treatment out-of-network or without insurance, you could face substantial bills. Confirm in-network participation with your health plan prior to booking.

Verified Clinical Procedures & Surgical Focus

Official annual procedure volumes, customary fee comparisons, and clinical focus areas.

Clinical Procedure & CodeAnnual ServicesDoctor ChargePeer NormStandard Baselinevs. Peer Norm
HCPCS Q9967
49,618$2.00$1.00$0.142x
HCPCS A9585
13,167$2.00$1.85$0.331.08x
CPT 71046
988$171.00$60.35$38.722.83x
CPT 73630
652$161.95$61.00$39.032.65x
CPT 73564
434$228.62$99.00$54.202.31x
CPT 73030
423$159.00$68.00$40.282.34x
CPT 73502
352$194.98$76.63$53.812.54x
CPT 72100
270$177.08$75.00$44.562.36x
👨‍⚕️ Physician & Medical Billing Intelligence (Click to view professional coding data)Expand ↓

This section provides clinical practice analytics for healthcare administrators, billing coders, and peer physicians evaluating practice benchmarks:

Evaluation & Management Mix

Estimated appointment time calculation: N/A. Indicates the proportion of high-complexity (99205/99215) vs. moderate-complexity (99204/99214) documentation relative to national specialty peers.

Charge-to-Payment Ratio

Gross charge multiplier: 5.41x. Useful for fee schedule alignment, out-of-network charge master analysis, and payer contract negotiations.

Patient Guidance: What to Ask Before Your Appointment

  • In-Network Confirmation: Confirm directly with your insurance plan that Dr. Nguyen participates in your specific network tier.
  • Surgical Facility Fees: If having surgery, verify whether it will be in a hospital or an outpatient surgery center. Facility charges are billed separately from physician fees.
  • Written Estimates: If you are paying out of pocket or have a high deductible, request a written good-faith estimate before major treatments.