| National Provider Identifier [NPI]: | 1801893474 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | JOE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 220 N RIDGEWAY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLEBURNE |
| Zip Code Of The Provider | 760334115 |
| 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 | 189 |
| Number Of Services | 13436 |
| Number Of Medicare Beneficiaries | 544 |
| Total Submitted Charge Amount | 738240.46 |
| Total Medicare Allowed Amount | 361325.26 |
| Total Medicare Payment Amount | 273894.29 |
| Total Medicare Standardized Payment Amount | 284790.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 26 |
| Number Of Drug Services | 2092 |
| Number Of Medicare Beneficiaries With Drug Services | 308 |
| Total Drug Submitted ChargeAmount | 39186.61 |
| Total Drug Medicare AllowedAmount | 16375.59 |
| Total Drug Medicare PaymentAmount | 14946.59 |
| Total Drug Medicare Standardized Payment Amount | 14946.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 163 |
| Number Of Medical Services | 11344 |
| Number Of Medicare Beneficiaries With Medical Services | 544 |
| Total Medical Submitted Charge Amount | 699053.85 |
| Total Medical Medicare Allowed Amount | 344949.67 |
| Total Medical Medicare Payment Amount | 258947.7 |
| Total Medical Medicare Standardized Payment Amount | 269843.85 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 271 |
| Number Of Beneficiaries Age 75 to 84 | 153 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 305 |
| Number Of Male Beneficiaries | 239 |
| Number Of Non Hispanic White Beneficiaries | 495 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 481 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.216 |