National Provider Identifier [NPI]: |
1871706754 |
Last Name Of The Provider |
JOHNSTON |
First Name Of The Provider |
CHRISTINE |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
164 SUMMIT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
PROVIDENCE |
Zip Code Of The Provider |
029062853 |
State Code Of The Provider |
RI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
1190 |
Number Of Medicare Beneficiaries |
431 |
Total Submitted Charge Amount |
2474616.5 |
Total Medicare Allowed Amount |
86031.34 |
Total Medicare Payment Amount |
67014.31 |
Total Medicare Standardized Payment Amount |
66411.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
577 |
Number Of Medicare Beneficiaries With Drug Services |
140 |
Total Drug Submitted ChargeAmount |
15850 |
Total Drug Medicare AllowedAmount |
178.49 |
Total Drug Medicare PaymentAmount |
139.46 |
Total Drug Medicare Standardized Payment Amount |
139.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
613 |
Number Of Medicare Beneficiaries With Medical Services |
431 |
Total Medical Submitted Charge Amount |
2458766.5 |
Total Medical Medicare Allowed Amount |
85852.85 |
Total Medical Medicare Payment Amount |
66874.85 |
Total Medical Medicare Standardized Payment Amount |
66272.06 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
162 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
260 |
Number Of Male Beneficiaries |
171 |
Number Of Non Hispanic White Beneficiaries |
362 |
Number Of Black or African American Beneficiaries |
47 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
278 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
153 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.6872 |