| National Provider Identifier [NPI]: | 1164401980 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1108 ROSS CLARK CIRCLE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOTHAN |
| Zip Code Of The Provider | 36301 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 2385 |
| Number Of Medicare Beneficiaries | 2220 |
| Total Submitted Charge Amount | 609459.87 |
| Total Medicare Allowed Amount | 154104.86 |
| Total Medicare Payment Amount | 116155.12 |
| Total Medicare Standardized Payment Amount | 125227.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 2385 |
| Number Of Medicare Beneficiaries With Medical Services | 2220 |
| Total Medical Submitted Charge Amount | 609459.87 |
| Total Medical Medicare Allowed Amount | 154104.86 |
| Total Medical Medicare Payment Amount | 116155.12 |
| Total Medical Medicare Standardized Payment Amount | 125227.97 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 367 |
| Number Of Beneficiaries Age 65 to 74 | 1162 |
| Number Of Beneficiaries Age 75 to 84 | 610 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 1341 |
| Number Of Male Beneficiaries | 879 |
| Number Of Non Hispanic White Beneficiaries | 1815 |
| Number Of Black or African American Beneficiaries | 371 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1770 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 450 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0154 |