National Provider Identifier [NPI]: |
1497992077 |
Last Name Of The Provider |
JOHNSON |
First Name Of The Provider |
DANA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
618 PLEASANTVILLE RD |
Street Address 2 Of The Provider |
SUITE 203 |
City Of The Provider |
LANCASTER |
Zip Code Of The Provider |
431303312 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1566 |
Number Of Medicare Beneficiaries |
259 |
Total Submitted Charge Amount |
98767 |
Total Medicare Allowed Amount |
56761.77 |
Total Medicare Payment Amount |
41161.67 |
Total Medicare Standardized Payment Amount |
52861.78 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
929 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
12061 |
Total Drug Medicare AllowedAmount |
11742.45 |
Total Drug Medicare PaymentAmount |
9202.72 |
Total Drug Medicare Standardized Payment Amount |
9202.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
637 |
Number Of Medicare Beneficiaries With Medical Services |
259 |
Total Medical Submitted Charge Amount |
86706 |
Total Medical Medicare Allowed Amount |
45019.32 |
Total Medical Medicare Payment Amount |
31958.95 |
Total Medical Medicare Standardized Payment Amount |
43659.06 |
Average Age Of Beneficiaries |
63 |
Number Of Beneficiaries Age Less65 |
123 |
Number Of Beneficiaries Age 65 to 74 |
57 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
103 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
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 |
118 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
141 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.3626 |