| National Provider Identifier [NPI]: | 1952384364 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1460 NE MEDICAL CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEND |
| Zip Code Of The Provider | 977016061 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 191 |
| Number Of Services | 3705 |
| Number Of Medicare Beneficiaries | 2664 |
| Total Submitted Charge Amount | 189442.72 |
| Total Medicare Allowed Amount | 175923.49 |
| Total Medicare Payment Amount | 132138.32 |
| Total Medicare Standardized Payment Amount | 141813.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 291.74 |
| Total Drug Medicare AllowedAmount | 164.22 |
| Total Drug Medicare PaymentAmount | 128.76 |
| Total Drug Medicare Standardized Payment Amount | 128.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 189 |
| Number Of Medical Services | 3690 |
| Number Of Medicare Beneficiaries With Medical Services | 2664 |
| Total Medical Submitted Charge Amount | 189150.98 |
| Total Medical Medicare Allowed Amount | 175759.27 |
| Total Medical Medicare Payment Amount | 132009.56 |
| Total Medical Medicare Standardized Payment Amount | 141684.46 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 455 |
| Number Of Beneficiaries Age 65 to 74 | 1176 |
| Number Of Beneficiaries Age 75 to 84 | 714 |
| Number Of Beneficiaries Age Greater 84 | 319 |
| Number Of Female Beneficiaries | 1507 |
| Number Of Male Beneficiaries | 1157 |
| Number Of Non Hispanic White Beneficiaries | 2492 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 69 |
| Number Of American Indian Alaska Native Beneficiaries | 61 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2129 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 535 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.1867 |