National Provider Identifier [NPI]: |
1528010329 |
Last Name Of The Provider |
JOHNSON |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9200 W WISCONSIN AVE |
Street Address 2 Of The Provider |
DIVISION OF TRANSPLANT SURGERY |
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532263522 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
76 |
Number Of Services |
790 |
Number Of Medicare Beneficiaries |
261 |
Total Submitted Charge Amount |
1572697 |
Total Medicare Allowed Amount |
216509.78 |
Total Medicare Payment Amount |
171743.29 |
Total Medicare Standardized Payment Amount |
181052.34 |
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 |
76 |
Number Of Medical Services |
790 |
Number Of Medicare Beneficiaries With Medical Services |
261 |
Total Medical Submitted Charge Amount |
1572697 |
Total Medical Medicare Allowed Amount |
216509.78 |
Total Medical Medicare Payment Amount |
171743.29 |
Total Medical Medicare Standardized Payment Amount |
181052.34 |
Average Age Of Beneficiaries |
56 |
Number Of Beneficiaries Age Less65 |
183 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
149 |
Number Of Non Hispanic White Beneficiaries |
139 |
Number Of Black or African American Beneficiaries |
93 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
129 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
132 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
20 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
6.8289 |