| National Provider Identifier [NPI]: | 1275647117 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 415 S 28TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HATTIESBURG |
| Zip Code Of The Provider | 394017246 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 14663 |
| Number Of Medicare Beneficiaries | 7190 |
| Total Submitted Charge Amount | 740507.85 |
| Total Medicare Allowed Amount | 242466.38 |
| Total Medicare Payment Amount | 176743.24 |
| Total Medicare Standardized Payment Amount | 190454.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 454 |
| Number Of Medicare Beneficiaries With Drug Services | 187 |
| Total Drug Submitted ChargeAmount | 20057 |
| Total Drug Medicare AllowedAmount | 8056.27 |
| Total Drug Medicare PaymentAmount | 7626.4 |
| Total Drug Medicare Standardized Payment Amount | 7626.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 14209 |
| Number Of Medicare Beneficiaries With Medical Services | 7190 |
| Total Medical Submitted Charge Amount | 720450.85 |
| Total Medical Medicare Allowed Amount | 234410.11 |
| Total Medical Medicare Payment Amount | 169116.84 |
| Total Medical Medicare Standardized Payment Amount | 182827.76 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1662 |
| Number Of Beneficiaries Age 65 to 74 | 2711 |
| Number Of Beneficiaries Age 75 to 84 | 1986 |
| Number Of Beneficiaries Age Greater 84 | 831 |
| Number Of Female Beneficiaries | 3938 |
| Number Of Male Beneficiaries | 3252 |
| Number Of Non Hispanic White Beneficiaries | 5521 |
| Number Of Black or African American Beneficiaries | 1584 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4589 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2601 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7661 |