| National Provider Identifier [NPI]: | 1871896894 |
| Last Name Of The Provider | JOHNSTONE-PETTY |
| First Name Of The Provider | MARIANNE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MSN, FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3200 PROVIDENCE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | ANCHORAGE |
| Zip Code Of The Provider | 995084615 |
| State Code Of The Provider | AK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 359 |
| Number Of Medicare Beneficiaries | 91 |
| Total Submitted Charge Amount | 158304 |
| Total Medicare Allowed Amount | 41522.8 |
| Total Medicare Payment Amount | 32438.69 |
| Total Medicare Standardized Payment Amount | 28230.32 |
| 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 | 8 |
| Number Of Medical Services | 359 |
| Number Of Medicare Beneficiaries With Medical Services | 91 |
| Total Medical Submitted Charge Amount | 158304 |
| Total Medical Medicare Allowed Amount | 41522.8 |
| Total Medical Medicare Payment Amount | 32438.69 |
| Total Medical Medicare Standardized Payment Amount | 28230.32 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 25 |
| Number Of Beneficiaries Age 75 to 84 | 32 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 41 |
| Number Of Male Beneficiaries | 50 |
| Number Of Non Hispanic White Beneficiaries | 67 |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 53 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 36 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 69 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.476 |