| National Provider Identifier [NPI]: | 1679573745 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | LYDIA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5421 PATTERSON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232262003 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 5064 |
| Number Of Medicare Beneficiaries | 747 |
| Total Submitted Charge Amount | 306724 |
| Total Medicare Allowed Amount | 265094.35 |
| Total Medicare Payment Amount | 186641.56 |
| Total Medicare Standardized Payment Amount | 185158.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 80 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 17855 |
| Total Drug Medicare AllowedAmount | 17641.04 |
| Total Drug Medicare PaymentAmount | 12936.32 |
| Total Drug Medicare Standardized Payment Amount | 12936.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 4984 |
| Number Of Medicare Beneficiaries With Medical Services | 747 |
| Total Medical Submitted Charge Amount | 288869 |
| Total Medical Medicare Allowed Amount | 247453.31 |
| Total Medical Medicare Payment Amount | 173705.24 |
| Total Medical Medicare Standardized Payment Amount | 172222.08 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 443 |
| Number Of Beneficiaries Age 75 to 84 | 215 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 420 |
| Number Of Male Beneficiaries | 327 |
| Number Of Non Hispanic White Beneficiaries | 688 |
| Number Of Black or African American Beneficiaries | 30 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.7643 |