National Provider Identifier [NPI]: |
1962730267 |
Last Name Of The Provider |
JOHNSON |
First Name Of The Provider |
MARQUITA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2591 FM 423 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LITTLE ELM |
Zip Code Of The Provider |
750686664 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
262 |
Number Of Medicare Beneficiaries |
129 |
Total Submitted Charge Amount |
10134.06 |
Total Medicare Allowed Amount |
9296.92 |
Total Medicare Payment Amount |
7536 |
Total Medicare Standardized Payment Amount |
8760.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
98 |
Number Of Medicare Beneficiaries With Drug Services |
86 |
Total Drug Submitted ChargeAmount |
3106.06 |
Total Drug Medicare AllowedAmount |
3106.06 |
Total Drug Medicare PaymentAmount |
3043.12 |
Total Drug Medicare Standardized Payment Amount |
3043.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
164 |
Number Of Medicare Beneficiaries With Medical Services |
129 |
Total Medical Submitted Charge Amount |
7028 |
Total Medical Medicare Allowed Amount |
6190.86 |
Total Medical Medicare Payment Amount |
4492.88 |
Total Medical Medicare Standardized Payment Amount |
5717.12 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
76 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
114 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
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 |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
12 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7027 |