| National Provider Identifier [NPI]: | 1093822538 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | PATRICIA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 BRAMBLE ST |
| Street Address 2 Of The Provider | SUITE 3 |
| City Of The Provider | CAMBRIDGE |
| Zip Code Of The Provider | 216132408 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 4562 |
| Number Of Medicare Beneficiaries | 654 |
| Total Submitted Charge Amount | 300572.91 |
| Total Medicare Allowed Amount | 245621.45 |
| Total Medicare Payment Amount | 184718.27 |
| Total Medicare Standardized Payment Amount | 181981.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 1614 |
| Number Of Medicare Beneficiaries With Drug Services | 203 |
| Total Drug Submitted ChargeAmount | 41238.5 |
| Total Drug Medicare AllowedAmount | 32368 |
| Total Drug Medicare PaymentAmount | 27587.63 |
| Total Drug Medicare Standardized Payment Amount | 27587.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 2948 |
| Number Of Medicare Beneficiaries With Medical Services | 654 |
| Total Medical Submitted Charge Amount | 259334.41 |
| Total Medical Medicare Allowed Amount | 213253.45 |
| Total Medical Medicare Payment Amount | 157130.64 |
| Total Medical Medicare Standardized Payment Amount | 154393.88 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 227 |
| Number Of Beneficiaries Age 75 to 84 | 202 |
| Number Of Beneficiaries Age Greater 84 | 179 |
| Number Of Female Beneficiaries | 456 |
| Number Of Male Beneficiaries | 198 |
| Number Of Non Hispanic White Beneficiaries | 546 |
| 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 | 465 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 189 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4015 |