National Provider Identifier [NPI]: |
1972556330 |
Last Name Of The Provider |
JOHNSTON |
First Name Of The Provider |
ROSWELL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1753 W RIDGEWAY |
Street Address 2 Of The Provider |
STE 103 |
City Of The Provider |
WATERLOO |
Zip Code Of The Provider |
507014521 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
124 |
Number Of Services |
3498 |
Number Of Medicare Beneficiaries |
682 |
Total Submitted Charge Amount |
1159686.75 |
Total Medicare Allowed Amount |
354321.64 |
Total Medicare Payment Amount |
272873.03 |
Total Medicare Standardized Payment Amount |
291485.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
786 |
Number Of Medicare Beneficiaries With Drug Services |
355 |
Total Drug Submitted ChargeAmount |
81876 |
Total Drug Medicare AllowedAmount |
36977.69 |
Total Drug Medicare PaymentAmount |
28835.02 |
Total Drug Medicare Standardized Payment Amount |
28835.02 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
121 |
Number Of Medical Services |
2712 |
Number Of Medicare Beneficiaries With Medical Services |
682 |
Total Medical Submitted Charge Amount |
1077810.75 |
Total Medical Medicare Allowed Amount |
317343.95 |
Total Medical Medicare Payment Amount |
244038.01 |
Total Medical Medicare Standardized Payment Amount |
262650.69 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
305 |
Number Of Beneficiaries Age 75 to 84 |
230 |
Number Of Beneficiaries Age Greater 84 |
108 |
Number Of Female Beneficiaries |
389 |
Number Of Male Beneficiaries |
293 |
Number Of Non Hispanic White Beneficiaries |
660 |
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 |
618 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
64 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
73 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.0888 |