| National Provider Identifier [NPI]: | 1417930652 |
| Last Name Of The Provider | JOHNSTON |
| First Name Of The Provider | KAY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3123 GREEN MEADOW DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN ANGELO |
| Zip Code Of The Provider | 769046977 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 3513 |
| Number Of Medicare Beneficiaries | 643 |
| Total Submitted Charge Amount | 363138.95 |
| Total Medicare Allowed Amount | 296024.78 |
| Total Medicare Payment Amount | 220411.13 |
| Total Medicare Standardized Payment Amount | 235688.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 53 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 6205 |
| Total Drug Medicare AllowedAmount | 5850.51 |
| Total Drug Medicare PaymentAmount | 4505.37 |
| Total Drug Medicare Standardized Payment Amount | 4505.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 3460 |
| Number Of Medicare Beneficiaries With Medical Services | 643 |
| Total Medical Submitted Charge Amount | 356933.95 |
| Total Medical Medicare Allowed Amount | 290174.27 |
| Total Medical Medicare Payment Amount | 215905.76 |
| Total Medical Medicare Standardized Payment Amount | 231183.46 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 231 |
| Number Of Beneficiaries Age 75 to 84 | 276 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 299 |
| Number Of Male Beneficiaries | 344 |
| Number Of Non Hispanic White Beneficiaries | 612 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 610 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0463 |