| National Provider Identifier [NPI]: | 1487640447 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | BRENT |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 AINSWORTH DR |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | PRESCOTT |
| Zip Code Of The Provider | 863051667 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 232 |
| Number Of Services | 16910 |
| Number Of Medicare Beneficiaries | 4091 |
| Total Submitted Charge Amount | 1366878.71 |
| Total Medicare Allowed Amount | 391003.77 |
| Total Medicare Payment Amount | 302784.69 |
| Total Medicare Standardized Payment Amount | 308196.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 9804 |
| Number Of Medicare Beneficiaries With Drug Services | 146 |
| Total Drug Submitted ChargeAmount | 11895.71 |
| Total Drug Medicare AllowedAmount | 3035.69 |
| Total Drug Medicare PaymentAmount | 2322.46 |
| Total Drug Medicare Standardized Payment Amount | 2322.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 227 |
| Number Of Medical Services | 7106 |
| Number Of Medicare Beneficiaries With Medical Services | 4091 |
| Total Medical Submitted Charge Amount | 1354983 |
| Total Medical Medicare Allowed Amount | 387968.08 |
| Total Medical Medicare Payment Amount | 300462.23 |
| Total Medical Medicare Standardized Payment Amount | 305874.02 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 299 |
| Number Of Beneficiaries Age 65 to 74 | 1837 |
| Number Of Beneficiaries Age 75 to 84 | 1357 |
| Number Of Beneficiaries Age Greater 84 | 598 |
| Number Of Female Beneficiaries | 2590 |
| Number Of Male Beneficiaries | 1501 |
| Number Of Non Hispanic White Beneficiaries | 3866 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 126 |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3692 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 399 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1884 |