National Provider Identifier [NPI]: |
1801848486 |
Last Name Of The Provider |
JOHNSON |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000 LANGWORTHY ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DUBUQUE |
Zip Code Of The Provider |
520017313 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
103 |
Number Of Services |
3744 |
Number Of Medicare Beneficiaries |
1164 |
Total Submitted Charge Amount |
472869.5 |
Total Medicare Allowed Amount |
225263.13 |
Total Medicare Payment Amount |
166112.53 |
Total Medicare Standardized Payment Amount |
181544.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
296 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
1923.5 |
Total Drug Medicare AllowedAmount |
1245.05 |
Total Drug Medicare PaymentAmount |
1008.96 |
Total Drug Medicare Standardized Payment Amount |
1008.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
97 |
Number Of Medical Services |
3448 |
Number Of Medicare Beneficiaries With Medical Services |
1164 |
Total Medical Submitted Charge Amount |
470946 |
Total Medical Medicare Allowed Amount |
224018.08 |
Total Medical Medicare Payment Amount |
165103.57 |
Total Medical Medicare Standardized Payment Amount |
180535.37 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
78 |
Number Of Beneficiaries Age 65 to 74 |
442 |
Number Of Beneficiaries Age 75 to 84 |
414 |
Number Of Beneficiaries Age Greater 84 |
230 |
Number Of Female Beneficiaries |
553 |
Number Of Male Beneficiaries |
611 |
Number Of Non Hispanic White Beneficiaries |
1138 |
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 |
959 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
205 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.241 |