| National Provider Identifier [NPI]: | 1467414441 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 660 GOLDEN RIDGE RD |
| Street Address 2 Of The Provider | STE 250 |
| City Of The Provider | GOLDEN |
| Zip Code Of The Provider | 804019541 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Sports Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 1268 |
| Number Of Medicare Beneficiaries | 212 |
| Total Submitted Charge Amount | 326006.25 |
| Total Medicare Allowed Amount | 122486.17 |
| Total Medicare Payment Amount | 91099.14 |
| Total Medicare Standardized Payment Amount | 90510.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 497 |
| Number Of Medicare Beneficiaries With Drug Services | 95 |
| Total Drug Submitted ChargeAmount | 12423 |
| Total Drug Medicare AllowedAmount | 6971.29 |
| Total Drug Medicare PaymentAmount | 4269.9 |
| Total Drug Medicare Standardized Payment Amount | 4269.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 771 |
| Number Of Medicare Beneficiaries With Medical Services | 212 |
| Total Medical Submitted Charge Amount | 313583.25 |
| Total Medical Medicare Allowed Amount | 115514.88 |
| Total Medical Medicare Payment Amount | 86829.24 |
| Total Medical Medicare Standardized Payment Amount | 86241.01 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 98 |
| Number Of Beneficiaries Age 75 to 84 | 59 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 115 |
| Number Of Male Beneficiaries | 97 |
| Number Of Non Hispanic White Beneficiaries | 184 |
| 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 | 181 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1326 |