National Provider Identifier [NPI]: |
1134111339 |
Last Name Of The Provider |
JOHNSON |
First Name Of The Provider |
A |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 HAWKINS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
IOWA CITY |
Zip Code Of The Provider |
522421009 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
3273 |
Number Of Medicare Beneficiaries |
1882 |
Total Submitted Charge Amount |
1976269.5 |
Total Medicare Allowed Amount |
451507.62 |
Total Medicare Payment Amount |
334030.32 |
Total Medicare Standardized Payment Amount |
365844.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
39 |
Number Of Medical Services |
3273 |
Number Of Medicare Beneficiaries With Medical Services |
1882 |
Total Medical Submitted Charge Amount |
1976269.5 |
Total Medical Medicare Allowed Amount |
451507.62 |
Total Medical Medicare Payment Amount |
334030.32 |
Total Medical Medicare Standardized Payment Amount |
365844.3 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
202 |
Number Of Beneficiaries Age 65 to 74 |
805 |
Number Of Beneficiaries Age 75 to 84 |
632 |
Number Of Beneficiaries Age Greater 84 |
243 |
Number Of Female Beneficiaries |
1060 |
Number Of Male Beneficiaries |
822 |
Number Of Non Hispanic White Beneficiaries |
1759 |
Number Of Black or African American Beneficiaries |
43 |
Number Of AsianPacific Islander Beneficiaries |
29 |
Number Of Hispanic Beneficiaries |
31 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
1573 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
309 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0963 |