National Provider Identifier [NPI]: |
1881626216 |
Last Name Of The Provider |
JOHNSON |
First Name Of The Provider |
KATHERINE |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4500 E 9TH AVE |
Street Address 2 Of The Provider |
#450 |
City Of The Provider |
DENVER |
Zip Code Of The Provider |
802203911 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
270 |
Number Of Medicare Beneficiaries |
107 |
Total Submitted Charge Amount |
52462 |
Total Medicare Allowed Amount |
20161.24 |
Total Medicare Payment Amount |
15968.41 |
Total Medicare Standardized Payment Amount |
18707.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
24 |
Total Drug Submitted ChargeAmount |
3139 |
Total Drug Medicare AllowedAmount |
1297.06 |
Total Drug Medicare PaymentAmount |
1271.05 |
Total Drug Medicare Standardized Payment Amount |
1271.05 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
245 |
Number Of Medicare Beneficiaries With Medical Services |
107 |
Total Medical Submitted Charge Amount |
49323 |
Total Medical Medicare Allowed Amount |
18864.18 |
Total Medical Medicare Payment Amount |
14697.36 |
Total Medical Medicare Standardized Payment Amount |
17436.42 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
70 |
Number Of Beneficiaries Age 75 to 84 |
19 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
96 |
Number Of Male Beneficiaries |
11 |
Number Of Non Hispanic White Beneficiaries |
87 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
15 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
23 |
Percent Of With Hypertension |
34 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.8685 |