| National Provider Identifier [NPI]: | 1427132877 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | JANE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5142 MILLER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FLINT |
| Zip Code Of The Provider | 48507 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 2283 |
| Number Of Medicare Beneficiaries | 344 |
| Total Submitted Charge Amount | 199211 |
| Total Medicare Allowed Amount | 93922.67 |
| Total Medicare Payment Amount | 67120.15 |
| Total Medicare Standardized Payment Amount | 69714.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 561 |
| Number Of Medicare Beneficiaries With Drug Services | 196 |
| Total Drug Submitted ChargeAmount | 25748 |
| Total Drug Medicare AllowedAmount | 2554.46 |
| Total Drug Medicare PaymentAmount | 2166.33 |
| Total Drug Medicare Standardized Payment Amount | 2166.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 1722 |
| Number Of Medicare Beneficiaries With Medical Services | 344 |
| Total Medical Submitted Charge Amount | 173463 |
| Total Medical Medicare Allowed Amount | 91368.21 |
| Total Medical Medicare Payment Amount | 64953.82 |
| Total Medical Medicare Standardized Payment Amount | 67547.83 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 157 |
| Number Of Beneficiaries Age 65 to 74 | 110 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 220 |
| Number Of Male Beneficiaries | 124 |
| Number Of Non Hispanic White Beneficiaries | 311 |
| 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 | 200 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 144 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2794 |