| National Provider Identifier [NPI]: | 1184764235 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | PAM |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 837 CYPRESS CREEK PKWY |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770903423 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 1371 |
| Number Of Medicare Beneficiaries | 85 |
| Total Submitted Charge Amount | 250349.6 |
| Total Medicare Allowed Amount | 54988.82 |
| Total Medicare Payment Amount | 40978.85 |
| Total Medicare Standardized Payment Amount | 42449.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 47 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 3554 |
| Total Drug Medicare AllowedAmount | 746.01 |
| Total Drug Medicare PaymentAmount | 663.81 |
| Total Drug Medicare Standardized Payment Amount | 663.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 1324 |
| Number Of Medicare Beneficiaries With Medical Services | 85 |
| Total Medical Submitted Charge Amount | 246795.6 |
| Total Medical Medicare Allowed Amount | 54242.81 |
| Total Medical Medicare Payment Amount | 40315.04 |
| Total Medical Medicare Standardized Payment Amount | 41785.87 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 52 |
| Number Of Beneficiaries Age 75 to 84 | 15 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 61 |
| Number Of Male Beneficiaries | 24 |
| Number Of Non Hispanic White Beneficiaries | 49 |
| Number Of Black or African American Beneficiaries | 16 |
| 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 | 71 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 27 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9052 |