| National Provider Identifier [NPI]: | 1457360398 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | PAULA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4305 NEW SHEPHERDSVILLE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BARDSTOWN |
| Zip Code Of The Provider | 400049019 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 1743 |
| Number Of Medicare Beneficiaries | 237 |
| Total Submitted Charge Amount | 147881.7 |
| Total Medicare Allowed Amount | 82807.95 |
| Total Medicare Payment Amount | 61365.11 |
| Total Medicare Standardized Payment Amount | 65914.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 397 |
| Number Of Medicare Beneficiaries With Drug Services | 135 |
| Total Drug Submitted ChargeAmount | 11433.7 |
| Total Drug Medicare AllowedAmount | 5002.72 |
| Total Drug Medicare PaymentAmount | 4846.16 |
| Total Drug Medicare Standardized Payment Amount | 4846.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1346 |
| Number Of Medicare Beneficiaries With Medical Services | 237 |
| Total Medical Submitted Charge Amount | 136448 |
| Total Medical Medicare Allowed Amount | 77805.23 |
| Total Medical Medicare Payment Amount | 56518.95 |
| Total Medical Medicare Standardized Payment Amount | 61068.66 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 103 |
| Number Of Beneficiaries Age 65 to 74 | 90 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 149 |
| Number Of Male Beneficiaries | 88 |
| Number Of Non Hispanic White Beneficiaries | 223 |
| 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 | 131 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 106 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.1611 |