| National Provider Identifier [NPI]: | 1770596009 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15200 W SUNSET BLVD STE 107 |
| Street Address 2 Of The Provider | |
| City Of The Provider | PACIFIC PALISADES |
| Zip Code Of The Provider | 902723620 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 2318 |
| Number Of Medicare Beneficiaries | 387 |
| Total Submitted Charge Amount | 219180 |
| Total Medicare Allowed Amount | 112715.77 |
| Total Medicare Payment Amount | 85176.88 |
| Total Medicare Standardized Payment Amount | 78591.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 211 |
| Number Of Medicare Beneficiaries With Drug Services | 191 |
| Total Drug Submitted ChargeAmount | 12720 |
| Total Drug Medicare AllowedAmount | 6910.06 |
| Total Drug Medicare PaymentAmount | 6762.61 |
| Total Drug Medicare Standardized Payment Amount | 6762.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 2107 |
| Number Of Medicare Beneficiaries With Medical Services | 387 |
| Total Medical Submitted Charge Amount | 206460 |
| Total Medical Medicare Allowed Amount | 105805.71 |
| Total Medical Medicare Payment Amount | 78414.27 |
| Total Medical Medicare Standardized Payment Amount | 71828.57 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 224 |
| Number Of Beneficiaries Age 75 to 84 | 112 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 203 |
| Number Of Male Beneficiaries | 184 |
| Number Of Non Hispanic White Beneficiaries | 334 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 5 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 42 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6862 |