| National Provider Identifier [NPI]: | 1578556189 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD PL |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1805 CYPRESS BROOK DR |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | TRINITY |
| Zip Code Of The Provider | 346554417 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 19895 |
| Number Of Medicare Beneficiaries | 2352 |
| Total Submitted Charge Amount | 961153.46 |
| Total Medicare Allowed Amount | 873758.33 |
| Total Medicare Payment Amount | 644306.29 |
| Total Medicare Standardized Payment Amount | 640379.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 46 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 1319.02 |
| Total Drug Medicare AllowedAmount | 1286.86 |
| Total Drug Medicare PaymentAmount | 1015.34 |
| Total Drug Medicare Standardized Payment Amount | 1015.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 19849 |
| Number Of Medicare Beneficiaries With Medical Services | 2352 |
| Total Medical Submitted Charge Amount | 959834.44 |
| Total Medical Medicare Allowed Amount | 872471.47 |
| Total Medical Medicare Payment Amount | 643290.95 |
| Total Medical Medicare Standardized Payment Amount | 639364.13 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 925 |
| Number Of Beneficiaries Age 75 to 84 | 941 |
| Number Of Beneficiaries Age Greater 84 | 400 |
| Number Of Female Beneficiaries | 1231 |
| Number Of Male Beneficiaries | 1121 |
| Number Of Non Hispanic White Beneficiaries | 2283 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2284 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1405 |