National Provider Identifier [NPI]: |
1154769925 |
Last Name Of The Provider |
JOHNSON |
First Name Of The Provider |
JASMINE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
231 SPRINGSIDE DR |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
AKRON |
Zip Code Of The Provider |
443334530 |
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 |
10 |
Number Of Services |
182 |
Number Of Medicare Beneficiaries |
120 |
Total Submitted Charge Amount |
27325 |
Total Medicare Allowed Amount |
9223.48 |
Total Medicare Payment Amount |
7058.6 |
Total Medicare Standardized Payment Amount |
8313.63 |
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 |
10 |
Number Of Medical Services |
182 |
Number Of Medicare Beneficiaries With Medical Services |
120 |
Total Medical Submitted Charge Amount |
27325 |
Total Medical Medicare Allowed Amount |
9223.48 |
Total Medical Medicare Payment Amount |
7058.6 |
Total Medical Medicare Standardized Payment Amount |
8313.63 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
65 |
Number Of Male Beneficiaries |
55 |
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 |
46 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
33 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
50 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
71 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.1437 |