| National Provider Identifier [NPI]: | 1699175471 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | ANN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 363 FREMONT ST |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | BATTLE CREEK |
| Zip Code Of The Provider | 490173389 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 281 |
| Number Of Medicare Beneficiaries | 112 |
| Total Submitted Charge Amount | 21947 |
| Total Medicare Allowed Amount | 14126.67 |
| Total Medicare Payment Amount | 11579.37 |
| Total Medicare Standardized Payment Amount | 13412.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 61 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 3245 |
| Total Drug Medicare AllowedAmount | 2680.05 |
| Total Drug Medicare PaymentAmount | 2619.94 |
| Total Drug Medicare Standardized Payment Amount | 2619.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 220 |
| Number Of Medicare Beneficiaries With Medical Services | 112 |
| Total Medical Submitted Charge Amount | 18702 |
| Total Medical Medicare Allowed Amount | 11446.62 |
| Total Medical Medicare Payment Amount | 8959.43 |
| Total Medical Medicare Standardized Payment Amount | 10792.2 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 47 |
| Number Of Beneficiaries Age 75 to 84 | 17 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 81 |
| Number Of Male Beneficiaries | 31 |
| Number Of Non Hispanic White Beneficiaries | 98 |
| 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 | 90 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 28 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0985 |