National Provider Identifier [NPI]: |
1932332384 |
Last Name Of The Provider |
JOHNSTON |
First Name Of The Provider |
CINDY |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1945 VERSAILLES ST |
Street Address 2 Of The Provider |
2ND FLOOR |
City Of The Provider |
SARASOTA |
Zip Code Of The Provider |
342396900 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
65 |
Number Of Services |
10045.5 |
Number Of Medicare Beneficiaries |
342 |
Total Submitted Charge Amount |
576487.68 |
Total Medicare Allowed Amount |
268395.04 |
Total Medicare Payment Amount |
206306.12 |
Total Medicare Standardized Payment Amount |
199467.54 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
22 |
Number Of Drug Services |
8838.5 |
Number Of Medicare Beneficiaries With Drug Services |
139 |
Total Drug Submitted ChargeAmount |
332322.3 |
Total Drug Medicare AllowedAmount |
145295.17 |
Total Drug Medicare PaymentAmount |
112577.48 |
Total Drug Medicare Standardized Payment Amount |
112577.48 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
1207 |
Number Of Medicare Beneficiaries With Medical Services |
341 |
Total Medical Submitted Charge Amount |
244165.38 |
Total Medical Medicare Allowed Amount |
123099.87 |
Total Medical Medicare Payment Amount |
93728.64 |
Total Medical Medicare Standardized Payment Amount |
86890.06 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
142 |
Number Of Beneficiaries Age 75 to 84 |
120 |
Number Of Beneficiaries Age Greater 84 |
43 |
Number Of Female Beneficiaries |
235 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
293 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
25 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
310 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
31 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2899 |