National Provider Identifier [NPI]: |
1326144536 |
Last Name Of The Provider |
JOHNSON |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
212 HERITAGE PARK DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MURFREESBORO |
Zip Code Of The Provider |
371291549 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
194 |
Number Of Services |
16961 |
Number Of Medicare Beneficiaries |
2311 |
Total Submitted Charge Amount |
1294599 |
Total Medicare Allowed Amount |
238935.67 |
Total Medicare Payment Amount |
185934.28 |
Total Medicare Standardized Payment Amount |
205831.69 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
11859 |
Number Of Medicare Beneficiaries With Drug Services |
125 |
Total Drug Submitted ChargeAmount |
2452.96 |
Total Drug Medicare AllowedAmount |
2346.91 |
Total Drug Medicare PaymentAmount |
1690.62 |
Total Drug Medicare Standardized Payment Amount |
1690.62 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
190 |
Number Of Medical Services |
5102 |
Number Of Medicare Beneficiaries With Medical Services |
2310 |
Total Medical Submitted Charge Amount |
1292146.04 |
Total Medical Medicare Allowed Amount |
236588.76 |
Total Medical Medicare Payment Amount |
184243.66 |
Total Medical Medicare Standardized Payment Amount |
204141.07 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
457 |
Number Of Beneficiaries Age 65 to 74 |
899 |
Number Of Beneficiaries Age 75 to 84 |
630 |
Number Of Beneficiaries Age Greater 84 |
325 |
Number Of Female Beneficiaries |
1533 |
Number Of Male Beneficiaries |
778 |
Number Of Non Hispanic White Beneficiaries |
2089 |
Number Of Black or African American Beneficiaries |
161 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
1772 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
539 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.5738 |