| National Provider Identifier [NPI]: | 1366498545 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 EXECUTIVE CENTER PKWY |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | FREDERICKSBURG |
| Zip Code Of The Provider | 224013177 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 20477 |
| Number Of Medicare Beneficiaries | 1389 |
| Total Submitted Charge Amount | 4883596.05 |
| Total Medicare Allowed Amount | 3624718.98 |
| Total Medicare Payment Amount | 2796000.48 |
| Total Medicare Standardized Payment Amount | 2740137.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 5553 |
| Number Of Medicare Beneficiaries With Drug Services | 255 |
| Total Drug Submitted ChargeAmount | 2513392.05 |
| Total Drug Medicare AllowedAmount | 2365386.45 |
| Total Drug Medicare PaymentAmount | 1854126.63 |
| Total Drug Medicare Standardized Payment Amount | 1854126.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 14924 |
| Number Of Medicare Beneficiaries With Medical Services | 1389 |
| Total Medical Submitted Charge Amount | 2370204 |
| Total Medical Medicare Allowed Amount | 1259332.53 |
| Total Medical Medicare Payment Amount | 941873.85 |
| Total Medical Medicare Standardized Payment Amount | 886010.72 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 487 |
| Number Of Beneficiaries Age 75 to 84 | 490 |
| Number Of Beneficiaries Age Greater 84 | 369 |
| Number Of Female Beneficiaries | 858 |
| Number Of Male Beneficiaries | 531 |
| Number Of Non Hispanic White Beneficiaries | 1166 |
| Number Of Black or African American Beneficiaries | 116 |
| Number Of AsianPacific Islander Beneficiaries | 50 |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1259 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 130 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2406 |