| National Provider Identifier [NPI]: | 1003878448 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 501 E HAMPDEN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ENGLEWOOD |
| Zip Code Of The Provider | 801132702 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 137 |
| Number Of Services | 8437 |
| Number Of Medicare Beneficiaries | 3113 |
| Total Submitted Charge Amount | 652193.5 |
| Total Medicare Allowed Amount | 219398.65 |
| Total Medicare Payment Amount | 173003.03 |
| Total Medicare Standardized Payment Amount | 174356.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 4140 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 4924 |
| Total Drug Medicare AllowedAmount | 1031.96 |
| Total Drug Medicare PaymentAmount | 809.02 |
| Total Drug Medicare Standardized Payment Amount | 809.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 135 |
| Number Of Medical Services | 4297 |
| Number Of Medicare Beneficiaries With Medical Services | 3113 |
| Total Medical Submitted Charge Amount | 647269.5 |
| Total Medical Medicare Allowed Amount | 218366.69 |
| Total Medical Medicare Payment Amount | 172194.01 |
| Total Medical Medicare Standardized Payment Amount | 173547.54 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 406 |
| Number Of Beneficiaries Age 65 to 74 | 1308 |
| Number Of Beneficiaries Age 75 to 84 | 865 |
| Number Of Beneficiaries Age Greater 84 | 534 |
| Number Of Female Beneficiaries | 1963 |
| Number Of Male Beneficiaries | 1150 |
| Number Of Non Hispanic White Beneficiaries | 2744 |
| Number Of Black or African American Beneficiaries | 100 |
| Number Of AsianPacific Islander Beneficiaries | 48 |
| Number Of Hispanic Beneficiaries | 164 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2580 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 533 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6391 |