National Provider Identifier [NPI]: |
1780699264 |
Last Name Of The Provider |
BALDWIN-JOHNSON |
First Name Of The Provider |
CATHY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2250 S WOODWORTH LOOP |
Street Address 2 Of The Provider |
SUITE 101 |
City Of The Provider |
PALMER |
Zip Code Of The Provider |
996457412 |
State Code Of The Provider |
AK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
367 |
Number Of Medicare Beneficiaries |
42 |
Total Submitted Charge Amount |
43539 |
Total Medicare Allowed Amount |
15556.12 |
Total Medicare Payment Amount |
12056.82 |
Total Medicare Standardized Payment Amount |
10038.73 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
548 |
Total Drug Medicare AllowedAmount |
499.88 |
Total Drug Medicare PaymentAmount |
489.89 |
Total Drug Medicare Standardized Payment Amount |
489.89 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
30 |
Number Of Medical Services |
352 |
Number Of Medicare Beneficiaries With Medical Services |
42 |
Total Medical Submitted Charge Amount |
42991 |
Total Medical Medicare Allowed Amount |
15056.24 |
Total Medical Medicare Payment Amount |
11566.93 |
Total Medical Medicare Standardized Payment Amount |
9548.84 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
18 |
Number Of Beneficiaries Age 75 to 84 |
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Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
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Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
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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 |
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Percent Of With Alzheimers Disease or Dementia |
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Percent Of With Asthma |
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Percent Of With Cancer |
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Percent Of With Heart Failure |
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Percent Of With Chronic Kidney Disease |
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Percent Of With Chronic Obstructive Pulmonary Disease |
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Percent Of With Depression |
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Percent Of With Diabetes |
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Percent Of With Hyperlipidemia |
26 |
Percent Of With Hypertension |
38 |
Percent Of With Ischemic Heart Disease |
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Percent Of With Osteoporosis |
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Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6768 |