| National Provider Identifier [NPI]: | 1740279843 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1646 W CHESTER PIKE |
| Street Address 2 Of The Provider | SUITE 21 |
| City Of The Provider | WEST CHESTER |
| Zip Code Of The Provider | 193827995 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 1205 |
| Number Of Medicare Beneficiaries | 301 |
| Total Submitted Charge Amount | 135745 |
| Total Medicare Allowed Amount | 113426.88 |
| Total Medicare Payment Amount | 84249.68 |
| Total Medicare Standardized Payment Amount | 80934.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 225 |
| Number Of Medicare Beneficiaries With Drug Services | 166 |
| Total Drug Submitted ChargeAmount | 22955 |
| Total Drug Medicare AllowedAmount | 16567.32 |
| Total Drug Medicare PaymentAmount | 15382.69 |
| Total Drug Medicare Standardized Payment Amount | 15382.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 980 |
| Number Of Medicare Beneficiaries With Medical Services | 301 |
| Total Medical Submitted Charge Amount | 112790 |
| Total Medical Medicare Allowed Amount | 96859.56 |
| Total Medical Medicare Payment Amount | 68866.99 |
| Total Medical Medicare Standardized Payment Amount | 65552.13 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 177 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 240 |
| Number Of Male Beneficiaries | 61 |
| Number Of Non Hispanic White Beneficiaries | 280 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 0.9071 |