| National Provider Identifier [NPI]: | 1265873335 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | KRISTIN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5694 MIDLAND RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREELAND |
| Zip Code Of The Provider | 486238845 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 332 |
| Number Of Medicare Beneficiaries | 153 |
| Total Submitted Charge Amount | 32293 |
| Total Medicare Allowed Amount | 19051.09 |
| Total Medicare Payment Amount | 12736.24 |
| Total Medicare Standardized Payment Amount | 16051.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 1139 |
| Total Drug Medicare AllowedAmount | 945.2 |
| Total Drug Medicare PaymentAmount | 925.74 |
| Total Drug Medicare Standardized Payment Amount | 925.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 297 |
| Number Of Medicare Beneficiaries With Medical Services | 153 |
| Total Medical Submitted Charge Amount | 31154 |
| Total Medical Medicare Allowed Amount | 18105.89 |
| Total Medical Medicare Payment Amount | 11810.5 |
| Total Medical Medicare Standardized Payment Amount | 15125.83 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | 45 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 98 |
| Number Of Male Beneficiaries | 55 |
| 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 | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9487 |