| National Provider Identifier [NPI]: | 1730321241 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | C.R.N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 998 HOSPITALITY WAY, SUITE 102 |
| Street Address 2 Of The Provider | BAYSIDE INTERNAL MEDICINE, LLC |
| City Of The Provider | ABERDEEN |
| Zip Code Of The Provider | 210011757 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 669 |
| Number Of Medicare Beneficiaries | 254 |
| Total Submitted Charge Amount | 62970 |
| Total Medicare Allowed Amount | 37572.34 |
| Total Medicare Payment Amount | 30056.27 |
| Total Medicare Standardized Payment Amount | 32710.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 88 |
| Number Of Medicare Beneficiaries With Drug Services | 65 |
| Total Drug Submitted ChargeAmount | 2825 |
| Total Drug Medicare AllowedAmount | 1929.07 |
| Total Drug Medicare PaymentAmount | 1885.81 |
| Total Drug Medicare Standardized Payment Amount | 1885.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 581 |
| Number Of Medicare Beneficiaries With Medical Services | 254 |
| Total Medical Submitted Charge Amount | 60145 |
| Total Medical Medicare Allowed Amount | 35643.27 |
| Total Medical Medicare Payment Amount | 28170.46 |
| Total Medical Medicare Standardized Payment Amount | 30824.55 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 98 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 181 |
| Number Of Male Beneficiaries | 73 |
| Number Of Non Hispanic White Beneficiaries | 223 |
| 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 | 187 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2152 |