National Provider Identifier [NPI]: |
1083660864 |
Last Name Of The Provider |
JOHNSON |
First Name Of The Provider |
BRYCE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
24331 EL TORO RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
LAGUNA WOODS |
Zip Code Of The Provider |
926372752 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
72 |
Number Of Services |
2247 |
Number Of Medicare Beneficiaries |
442 |
Total Submitted Charge Amount |
641402.04 |
Total Medicare Allowed Amount |
224775.03 |
Total Medicare Payment Amount |
168336.79 |
Total Medicare Standardized Payment Amount |
153422.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
200 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
3580 |
Total Drug Medicare AllowedAmount |
1064.02 |
Total Drug Medicare PaymentAmount |
824.49 |
Total Drug Medicare Standardized Payment Amount |
824.49 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
70 |
Number Of Medical Services |
2047 |
Number Of Medicare Beneficiaries With Medical Services |
442 |
Total Medical Submitted Charge Amount |
637822.04 |
Total Medical Medicare Allowed Amount |
223711.01 |
Total Medical Medicare Payment Amount |
167512.3 |
Total Medical Medicare Standardized Payment Amount |
152598.12 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
21 |
Number Of Beneficiaries Age 65 to 74 |
185 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
279 |
Number Of Male Beneficiaries |
163 |
Number Of Non Hispanic White Beneficiaries |
384 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
24 |
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
392 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
21 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3579 |