| National Provider Identifier [NPI]: | 1982692307 |
| Last Name Of The Provider | JOHNSTON |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13600 E 86TH ST N |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | OWASSO |
| Zip Code Of The Provider | 740558731 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 1104 |
| Number Of Medicare Beneficiaries | 291 |
| Total Submitted Charge Amount | 132526.1 |
| Total Medicare Allowed Amount | 69391.58 |
| Total Medicare Payment Amount | 43855.26 |
| Total Medicare Standardized Payment Amount | 49561.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 212 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 2885 |
| Total Drug Medicare AllowedAmount | 1446.1 |
| Total Drug Medicare PaymentAmount | 1337.95 |
| Total Drug Medicare Standardized Payment Amount | 1337.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 892 |
| Number Of Medicare Beneficiaries With Medical Services | 291 |
| Total Medical Submitted Charge Amount | 129641.1 |
| Total Medical Medicare Allowed Amount | 67945.48 |
| Total Medical Medicare Payment Amount | 42517.31 |
| Total Medical Medicare Standardized Payment Amount | 48223.8 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 153 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 171 |
| Number Of Male Beneficiaries | 120 |
| Number Of Non Hispanic White Beneficiaries | 254 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 22 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 275 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9305 |