National Provider Identifier [NPI]: |
1891757464 |
Last Name Of The Provider |
JOHNSTON |
First Name Of The Provider |
GEORGE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
825 BENNETT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEDFORD |
Zip Code Of The Provider |
975046715 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
85 |
Number Of Services |
24020 |
Number Of Medicare Beneficiaries |
676 |
Total Submitted Charge Amount |
2727889 |
Total Medicare Allowed Amount |
766491.7 |
Total Medicare Payment Amount |
624337.18 |
Total Medicare Standardized Payment Amount |
589187.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
6102 |
Number Of Medicare Beneficiaries With Drug Services |
294 |
Total Drug Submitted ChargeAmount |
18942 |
Total Drug Medicare AllowedAmount |
9791.14 |
Total Drug Medicare PaymentAmount |
7541.68 |
Total Drug Medicare Standardized Payment Amount |
7541.68 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
73 |
Number Of Medical Services |
17918 |
Number Of Medicare Beneficiaries With Medical Services |
676 |
Total Medical Submitted Charge Amount |
2708947 |
Total Medical Medicare Allowed Amount |
756700.56 |
Total Medical Medicare Payment Amount |
616795.5 |
Total Medical Medicare Standardized Payment Amount |
581645.62 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
273 |
Number Of Beneficiaries Age 65 to 74 |
252 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
399 |
Number Of Male Beneficiaries |
277 |
Number Of Non Hispanic White Beneficiaries |
629 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
12 |
Number Of Beneficiaries With Medicare Only Entitlement |
469 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
207 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2273 |