| National Provider Identifier [NPI]: | 1083888937 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | KATHERINE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3885 UPHAM ST |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | WHEAT RIDGE |
| Zip Code Of The Provider | 800334880 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 5451 |
| Number Of Medicare Beneficiaries | 31 |
| Total Submitted Charge Amount | 27751.57 |
| Total Medicare Allowed Amount | 10858.2 |
| Total Medicare Payment Amount | 8512.8 |
| Total Medicare Standardized Payment Amount | 8495.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 5362 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 13614.57 |
| Total Drug Medicare AllowedAmount | 3611.19 |
| Total Drug Medicare PaymentAmount | 2831.13 |
| Total Drug Medicare Standardized Payment Amount | 2831.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 9 |
| Number Of Medical Services | 89 |
| Number Of Medicare Beneficiaries With Medical Services | 31 |
| Total Medical Submitted Charge Amount | 14137 |
| Total Medical Medicare Allowed Amount | 7247.01 |
| Total Medical Medicare Payment Amount | 5681.67 |
| Total Medical Medicare Standardized Payment Amount | 5664.26 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 13 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 16 |
| Number Of Male Beneficiaries | 15 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 52 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.1728 |