| National Provider Identifier [NPI]: | 1356563241 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | GIL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2511 A COLLEGE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CONWAY |
| Zip Code Of The Provider | 720346135 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 1946 |
| Number Of Medicare Beneficiaries | 222 |
| Total Submitted Charge Amount | 223185.35 |
| Total Medicare Allowed Amount | 145881.66 |
| Total Medicare Payment Amount | 107559.03 |
| Total Medicare Standardized Payment Amount | 123308.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 229 |
| Number Of Medicare Beneficiaries With Drug Services | 121 |
| Total Drug Submitted ChargeAmount | 4511.15 |
| Total Drug Medicare AllowedAmount | 1266.02 |
| Total Drug Medicare PaymentAmount | 1180.93 |
| Total Drug Medicare Standardized Payment Amount | 1180.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 1717 |
| Number Of Medicare Beneficiaries With Medical Services | 222 |
| Total Medical Submitted Charge Amount | 218674.2 |
| Total Medical Medicare Allowed Amount | 144615.64 |
| Total Medical Medicare Payment Amount | 106378.1 |
| Total Medical Medicare Standardized Payment Amount | 122127.12 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 108 |
| Number Of Beneficiaries Age 75 to 84 | 75 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 99 |
| Number Of Non Hispanic White Beneficiaries | 197 |
| 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 | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9772 |