| National Provider Identifier [NPI]: | 1346478054 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | LANDON |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1911 NORTH WEBB RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 67206 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 4802 |
| Number Of Medicare Beneficiaries | 761 |
| Total Submitted Charge Amount | 1358419 |
| Total Medicare Allowed Amount | 610961.51 |
| Total Medicare Payment Amount | 466965.46 |
| Total Medicare Standardized Payment Amount | 490985.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 246 |
| Number Of Medicare Beneficiaries With Drug Services | 102 |
| Total Drug Submitted ChargeAmount | 41099 |
| Total Drug Medicare AllowedAmount | 39274.63 |
| Total Drug Medicare PaymentAmount | 30243.17 |
| Total Drug Medicare Standardized Payment Amount | 30243.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 4556 |
| Number Of Medicare Beneficiaries With Medical Services | 761 |
| Total Medical Submitted Charge Amount | 1317320 |
| Total Medical Medicare Allowed Amount | 571686.88 |
| Total Medical Medicare Payment Amount | 436722.29 |
| Total Medical Medicare Standardized Payment Amount | 460741.89 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 347 |
| Number Of Beneficiaries Age 75 to 84 | 251 |
| Number Of Beneficiaries Age Greater 84 | 133 |
| Number Of Female Beneficiaries | 346 |
| Number Of Male Beneficiaries | 415 |
| Number Of Non Hispanic White Beneficiaries | 735 |
| 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 | 736 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9776 |