| National Provider Identifier [NPI]: | 1275518979 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | TODD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 524 S PARK ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | KALAMAZOO |
| Zip Code Of The Provider | 490075118 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 179 |
| Number Of Services | 7320 |
| Number Of Medicare Beneficiaries | 3032 |
| Total Submitted Charge Amount | 573848 |
| Total Medicare Allowed Amount | 144446.83 |
| Total Medicare Payment Amount | 112123.19 |
| Total Medicare Standardized Payment Amount | 115607.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1745 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 3839 |
| Total Drug Medicare AllowedAmount | 344.73 |
| Total Drug Medicare PaymentAmount | 270.24 |
| Total Drug Medicare Standardized Payment Amount | 270.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 178 |
| Number Of Medical Services | 5575 |
| Number Of Medicare Beneficiaries With Medical Services | 3032 |
| Total Medical Submitted Charge Amount | 570009 |
| Total Medical Medicare Allowed Amount | 144102.1 |
| Total Medical Medicare Payment Amount | 111852.95 |
| Total Medical Medicare Standardized Payment Amount | 115336.97 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 817 |
| Number Of Beneficiaries Age 65 to 74 | 1064 |
| Number Of Beneficiaries Age 75 to 84 | 734 |
| Number Of Beneficiaries Age Greater 84 | 417 |
| Number Of Female Beneficiaries | 1926 |
| Number Of Male Beneficiaries | 1106 |
| Number Of Non Hispanic White Beneficiaries | 2609 |
| Number Of Black or African American Beneficiaries | 296 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 88 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2000 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1032 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4797 |