National Provider Identifier [NPI]: |
1164404521 |
Last Name Of The Provider |
JOHNSON |
First Name Of The Provider |
ALAN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
303 PARKWAY DRIVE NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATLANTA |
Zip Code Of The Provider |
30312 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
185 |
Number Of Services |
4902 |
Number Of Medicare Beneficiaries |
2672 |
Total Submitted Charge Amount |
593910 |
Total Medicare Allowed Amount |
146462.45 |
Total Medicare Payment Amount |
115377.76 |
Total Medicare Standardized Payment Amount |
116385.11 |
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 |
185 |
Number Of Medical Services |
4902 |
Number Of Medicare Beneficiaries With Medical Services |
2672 |
Total Medical Submitted Charge Amount |
593910 |
Total Medical Medicare Allowed Amount |
146462.45 |
Total Medical Medicare Payment Amount |
115377.76 |
Total Medical Medicare Standardized Payment Amount |
116385.11 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
606 |
Number Of Beneficiaries Age 65 to 74 |
1042 |
Number Of Beneficiaries Age 75 to 84 |
714 |
Number Of Beneficiaries Age Greater 84 |
310 |
Number Of Female Beneficiaries |
1776 |
Number Of Male Beneficiaries |
896 |
Number Of Non Hispanic White Beneficiaries |
1698 |
Number Of Black or African American Beneficiaries |
889 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
36 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
28 |
Number Of Beneficiaries With Medicare Only Entitlement |
1946 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
726 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.7798 |