| National Provider Identifier [NPI]: | 1639169568 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | MARGARET |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4500 SAN PABLO RD S |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322241865 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Critical Care (Intensivists) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 5666 |
| Number Of Medicare Beneficiaries | 690 |
| Total Submitted Charge Amount | 176053.05 |
| Total Medicare Allowed Amount | 143563.95 |
| Total Medicare Payment Amount | 108225.07 |
| Total Medicare Standardized Payment Amount | 116182.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3891 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 3161.96 |
| Total Drug Medicare AllowedAmount | 2715.96 |
| Total Drug Medicare PaymentAmount | 1892.22 |
| Total Drug Medicare Standardized Payment Amount | 1892.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 1775 |
| Number Of Medicare Beneficiaries With Medical Services | 690 |
| Total Medical Submitted Charge Amount | 172891.09 |
| Total Medical Medicare Allowed Amount | 140847.99 |
| Total Medical Medicare Payment Amount | 106332.85 |
| Total Medical Medicare Standardized Payment Amount | 114289.87 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 101 |
| Number Of Beneficiaries Age 65 to 74 | 316 |
| Number Of Beneficiaries Age 75 to 84 | 209 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 362 |
| Number Of Male Beneficiaries | 328 |
| Number Of Non Hispanic White Beneficiaries | 602 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 625 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 48 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.808 |