| National Provider Identifier [NPI]: | 1891999272 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | KATHERINE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2555 PHILLIPS FIELD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FAIRBANKS |
| Zip Code Of The Provider | 997093933 |
| State Code Of The Provider | AK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 4374 |
| Number Of Medicare Beneficiaries | 586 |
| Total Submitted Charge Amount | 4183237 |
| Total Medicare Allowed Amount | 1072203.05 |
| Total Medicare Payment Amount | 812775.24 |
| Total Medicare Standardized Payment Amount | 715539.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 618 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 403844 |
| Total Drug Medicare AllowedAmount | 357739.89 |
| Total Drug Medicare PaymentAmount | 275255.64 |
| Total Drug Medicare Standardized Payment Amount | 275255.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 3756 |
| Number Of Medicare Beneficiaries With Medical Services | 586 |
| Total Medical Submitted Charge Amount | 3779393 |
| Total Medical Medicare Allowed Amount | 714463.16 |
| Total Medical Medicare Payment Amount | 537519.6 |
| Total Medical Medicare Standardized Payment Amount | 440283.4 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 283 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 322 |
| Number Of Male Beneficiaries | 264 |
| Number Of Non Hispanic White Beneficiaries | 509 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 32 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 516 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9591 |