| National Provider Identifier [NPI]: | 1215015482 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | BOYD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2431 W. CALDWELL AVE |
| Street Address 2 Of The Provider | VISALIA WALK - IN MEDICAL CLINIC |
| City Of The Provider | VISALIA |
| Zip Code Of The Provider | 93277 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 6498 |
| Number Of Medicare Beneficiaries | 1268 |
| Total Submitted Charge Amount | 517154.39 |
| Total Medicare Allowed Amount | 485676.87 |
| Total Medicare Payment Amount | 357882.54 |
| Total Medicare Standardized Payment Amount | 348270.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 1050 |
| Number Of Medicare Beneficiaries With Drug Services | 258 |
| Total Drug Submitted ChargeAmount | 26399 |
| Total Drug Medicare AllowedAmount | 2650.24 |
| Total Drug Medicare PaymentAmount | 2228.39 |
| Total Drug Medicare Standardized Payment Amount | 2228.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 5448 |
| Number Of Medicare Beneficiaries With Medical Services | 1268 |
| Total Medical Submitted Charge Amount | 490755.39 |
| Total Medical Medicare Allowed Amount | 483026.63 |
| Total Medical Medicare Payment Amount | 355654.15 |
| Total Medical Medicare Standardized Payment Amount | 346042.6 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 198 |
| Number Of Beneficiaries Age 65 to 74 | 514 |
| Number Of Beneficiaries Age 75 to 84 | 346 |
| Number Of Beneficiaries Age Greater 84 | 210 |
| Number Of Female Beneficiaries | 734 |
| Number Of Male Beneficiaries | 534 |
| Number Of Non Hispanic White Beneficiaries | 896 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 307 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 813 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 455 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.737 |