| National Provider Identifier [NPI]: | 1659356921 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | PHILLIP |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 HIGHLANDER PT DR |
| Street Address 2 Of The Provider | STE 300 |
| City Of The Provider | FLOYDS KNOBS |
| Zip Code Of The Provider | 47119 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 3775 |
| Number Of Medicare Beneficiaries | 488 |
| Total Submitted Charge Amount | 306133 |
| Total Medicare Allowed Amount | 174860.5 |
| Total Medicare Payment Amount | 131329.76 |
| Total Medicare Standardized Payment Amount | 132774.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 319 |
| Number Of Medicare Beneficiaries With Drug Services | 122 |
| Total Drug Submitted ChargeAmount | 5542 |
| Total Drug Medicare AllowedAmount | 2928.53 |
| Total Drug Medicare PaymentAmount | 2650.91 |
| Total Drug Medicare Standardized Payment Amount | 2650.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 3456 |
| Number Of Medicare Beneficiaries With Medical Services | 488 |
| Total Medical Submitted Charge Amount | 300591 |
| Total Medical Medicare Allowed Amount | 171931.97 |
| Total Medical Medicare Payment Amount | 128678.85 |
| Total Medical Medicare Standardized Payment Amount | 130123.91 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 235 |
| Number Of Beneficiaries Age 75 to 84 | 132 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 272 |
| Number Of Male Beneficiaries | 216 |
| Number Of Non Hispanic White Beneficiaries | 467 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 426 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0815 |