| National Provider Identifier [NPI]: | 1285692400 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1055 N 500 W |
| Street Address 2 Of The Provider | |
| City Of The Provider | PROVO |
| Zip Code Of The Provider | 846043305 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 7774 |
| Number Of Medicare Beneficiaries | 1361 |
| Total Submitted Charge Amount | 470534.32 |
| Total Medicare Allowed Amount | 244999.91 |
| Total Medicare Payment Amount | 184122.27 |
| Total Medicare Standardized Payment Amount | 194802.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 1340 |
| Number Of Medicare Beneficiaries With Drug Services | 210 |
| Total Drug Submitted ChargeAmount | 28983 |
| Total Drug Medicare AllowedAmount | 18506.8 |
| Total Drug Medicare PaymentAmount | 15507.09 |
| Total Drug Medicare Standardized Payment Amount | 15507.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 6434 |
| Number Of Medicare Beneficiaries With Medical Services | 1361 |
| Total Medical Submitted Charge Amount | 441551.32 |
| Total Medical Medicare Allowed Amount | 226493.11 |
| Total Medical Medicare Payment Amount | 168615.18 |
| Total Medical Medicare Standardized Payment Amount | 179295.18 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 532 |
| Number Of Beneficiaries Age 75 to 84 | 516 |
| Number Of Beneficiaries Age Greater 84 | 200 |
| Number Of Female Beneficiaries | 843 |
| Number Of Male Beneficiaries | 518 |
| Number Of Non Hispanic White Beneficiaries | 1292 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1233 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 128 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2173 |