| National Provider Identifier [NPI]: | 1447236112 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 885 KEMPSVILLE RD |
| Street Address 2 Of The Provider | SUITE 114 |
| City Of The Provider | NORFOLK |
| Zip Code Of The Provider | 235023800 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 2124 |
| Number Of Medicare Beneficiaries | 1102 |
| Total Submitted Charge Amount | 910605 |
| Total Medicare Allowed Amount | 280297.84 |
| Total Medicare Payment Amount | 214053.79 |
| Total Medicare Standardized Payment Amount | 221000.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 2124 |
| Number Of Medicare Beneficiaries With Medical Services | 1102 |
| Total Medical Submitted Charge Amount | 910605 |
| Total Medical Medicare Allowed Amount | 280297.84 |
| Total Medical Medicare Payment Amount | 214053.79 |
| Total Medical Medicare Standardized Payment Amount | 221000.41 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 128 |
| Number Of Beneficiaries Age 65 to 74 | 502 |
| Number Of Beneficiaries Age 75 to 84 | 347 |
| Number Of Beneficiaries Age Greater 84 | 125 |
| Number Of Female Beneficiaries | 641 |
| Number Of Male Beneficiaries | 461 |
| Number Of Non Hispanic White Beneficiaries | 799 |
| Number Of Black or African American Beneficiaries | 256 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 973 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 129 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6419 |