National Provider Identifier [NPI]: |
1174691257 |
Last Name Of The Provider |
JOHNS |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
201 203 MCLISTEN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MINGO JCT |
Zip Code Of The Provider |
43938 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
2638 |
Number Of Medicare Beneficiaries |
559 |
Total Submitted Charge Amount |
286213 |
Total Medicare Allowed Amount |
194356.88 |
Total Medicare Payment Amount |
144236.26 |
Total Medicare Standardized Payment Amount |
151197.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
81 |
Number Of Medicare Beneficiaries With Drug Services |
59 |
Total Drug Submitted ChargeAmount |
1985 |
Total Drug Medicare AllowedAmount |
666.86 |
Total Drug Medicare PaymentAmount |
606.22 |
Total Drug Medicare Standardized Payment Amount |
606.22 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
2557 |
Number Of Medicare Beneficiaries With Medical Services |
559 |
Total Medical Submitted Charge Amount |
284228 |
Total Medical Medicare Allowed Amount |
193690.02 |
Total Medical Medicare Payment Amount |
143630.04 |
Total Medical Medicare Standardized Payment Amount |
150591.34 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
117 |
Number Of Beneficiaries Age 65 to 74 |
175 |
Number Of Beneficiaries Age 75 to 84 |
161 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
318 |
Number Of Male Beneficiaries |
241 |
Number Of Non Hispanic White Beneficiaries |
509 |
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 |
356 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
203 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9301 |