| National Provider Identifier [NPI]: | 1699911578 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | PAMELA |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 N CAROLINE ST |
| Street Address 2 Of The Provider | ROOM 3140D |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212870006 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 1623 |
| Number Of Medicare Beneficiaries | 951 |
| Total Submitted Charge Amount | 721969 |
| Total Medicare Allowed Amount | 148868.82 |
| Total Medicare Payment Amount | 110811.6 |
| Total Medicare Standardized Payment Amount | 110207.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 68 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 10075 |
| Total Drug Medicare AllowedAmount | 11.98 |
| Total Drug Medicare PaymentAmount | 9.82 |
| Total Drug Medicare Standardized Payment Amount | 9.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 1555 |
| Number Of Medicare Beneficiaries With Medical Services | 951 |
| Total Medical Submitted Charge Amount | 711894 |
| Total Medical Medicare Allowed Amount | 148856.84 |
| Total Medical Medicare Payment Amount | 110801.78 |
| Total Medical Medicare Standardized Payment Amount | 110197.43 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 195 |
| Number Of Beneficiaries Age 65 to 74 | 433 |
| Number Of Beneficiaries Age 75 to 84 | 264 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 460 |
| Number Of Male Beneficiaries | 491 |
| Number Of Non Hispanic White Beneficiaries | 656 |
| Number Of Black or African American Beneficiaries | 232 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 757 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 194 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 28 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.2302 |