| National Provider Identifier [NPI]: | 1346220670 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | BRYAN |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1210 W FAIRVIEW ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLFAX |
| Zip Code Of The Provider | 991119552 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 16053.2 |
| Number Of Medicare Beneficiaries | 785 |
| Total Submitted Charge Amount | 1057846.5 |
| Total Medicare Allowed Amount | 626436.71 |
| Total Medicare Payment Amount | 465685.42 |
| Total Medicare Standardized Payment Amount | 469874.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 32 |
| Number Of Drug Services | 5475.2 |
| Number Of Medicare Beneficiaries With Drug Services | 323 |
| Total Drug Submitted ChargeAmount | 100533 |
| Total Drug Medicare AllowedAmount | 67329.28 |
| Total Drug Medicare PaymentAmount | 53138.51 |
| Total Drug Medicare Standardized Payment Amount | 53138.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 118 |
| Number Of Medical Services | 10578 |
| Number Of Medicare Beneficiaries With Medical Services | 785 |
| Total Medical Submitted Charge Amount | 957313.5 |
| Total Medical Medicare Allowed Amount | 559107.43 |
| Total Medical Medicare Payment Amount | 412546.91 |
| Total Medical Medicare Standardized Payment Amount | 416735.99 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 103 |
| Number Of Beneficiaries Age 65 to 74 | 261 |
| Number Of Beneficiaries Age 75 to 84 | 266 |
| Number Of Beneficiaries Age Greater 84 | 155 |
| Number Of Female Beneficiaries | 414 |
| Number Of Male Beneficiaries | 371 |
| Number Of Non Hispanic White Beneficiaries | 760 |
| 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 | 632 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 153 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3172 |