| National Provider Identifier [NPI]: | 1508912361 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | KATHERINE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 60 WASHINGTON BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | KENTON |
| Zip Code Of The Provider | 433262080 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 3779 |
| Number Of Medicare Beneficiaries | 683 |
| Total Submitted Charge Amount | 369182 |
| Total Medicare Allowed Amount | 244859.61 |
| Total Medicare Payment Amount | 176652.96 |
| Total Medicare Standardized Payment Amount | 182055.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 217 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 1685 |
| Total Drug Medicare AllowedAmount | 358.69 |
| Total Drug Medicare PaymentAmount | 314.35 |
| Total Drug Medicare Standardized Payment Amount | 314.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 3562 |
| Number Of Medicare Beneficiaries With Medical Services | 683 |
| Total Medical Submitted Charge Amount | 367497 |
| Total Medical Medicare Allowed Amount | 244500.92 |
| Total Medical Medicare Payment Amount | 176338.61 |
| Total Medical Medicare Standardized Payment Amount | 181741.31 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 105 |
| Number Of Beneficiaries Age 65 to 74 | 226 |
| Number Of Beneficiaries Age 75 to 84 | 194 |
| Number Of Beneficiaries Age Greater 84 | 158 |
| Number Of Female Beneficiaries | 447 |
| Number Of Male Beneficiaries | 236 |
| Number Of Non Hispanic White Beneficiaries | 653 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 494 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 189 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4171 |