| National Provider Identifier [NPI]: | 1922095959 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | BRENDA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | RPH |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 22277 MULHOLLAND HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | CALABASAS |
| Zip Code Of The Provider | 913025156 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Mass Immunization Roster Biller |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 384 |
| Number Of Medicare Beneficiaries | 182 |
| Total Submitted Charge Amount | 13436.33 |
| Total Medicare Allowed Amount | 8821.91 |
| Total Medicare Payment Amount | 8646.3 |
| Total Medicare Standardized Payment Amount | 8063.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 193 |
| Number Of Medicare Beneficiaries With Drug Services | 182 |
| Total Drug Submitted ChargeAmount | 7259.65 |
| Total Drug Medicare AllowedAmount | 3437.62 |
| Total Drug Medicare PaymentAmount | 3368.97 |
| Total Drug Medicare Standardized Payment Amount | 3368.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 2 |
| Number Of Medical Services | 191 |
| Number Of Medicare Beneficiaries With Medical Services | 181 |
| Total Medical Submitted Charge Amount | 6176.68 |
| Total Medical Medicare Allowed Amount | 5384.29 |
| Total Medical Medicare Payment Amount | 5277.33 |
| Total Medical Medicare Standardized Payment Amount | 4694.78 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 122 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 107 |
| Number Of Male Beneficiaries | 75 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 7 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.793 |