National Provider Identifier [NPI]: |
1972735256 |
Last Name Of The Provider |
LAGUNA |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
PH.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12512 BRUCE B. DOWNS BOULEVARD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336129209 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
1352 |
Number Of Medicare Beneficiaries |
411 |
Total Submitted Charge Amount |
171550 |
Total Medicare Allowed Amount |
129158.78 |
Total Medicare Payment Amount |
98444.93 |
Total Medicare Standardized Payment Amount |
94915.19 |
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 |
6 |
Number Of Medical Services |
1352 |
Number Of Medicare Beneficiaries With Medical Services |
411 |
Total Medical Submitted Charge Amount |
171550 |
Total Medical Medicare Allowed Amount |
129158.78 |
Total Medical Medicare Payment Amount |
98444.93 |
Total Medical Medicare Standardized Payment Amount |
94915.19 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
132 |
Number Of Beneficiaries Age Greater 84 |
162 |
Number Of Female Beneficiaries |
259 |
Number Of Male Beneficiaries |
152 |
Number Of Non Hispanic White Beneficiaries |
386 |
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 |
351 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
48 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
68 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
2.049 |