| National Provider Identifier [NPI]: | 1710212816 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | KIMBERLY |
| Middle Initial Of The Provider | Z |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3601 SW 160TH AVE |
| Street Address 2 Of The Provider | SUITE 250 |
| City Of The Provider | MIRAMAR |
| Zip Code Of The Provider | 330276308 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 1079 |
| Number Of Medicare Beneficiaries | 249 |
| Total Submitted Charge Amount | 88098 |
| Total Medicare Allowed Amount | 39188.46 |
| Total Medicare Payment Amount | 25941.38 |
| Total Medicare Standardized Payment Amount | 28234.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 147 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 4091 |
| Total Drug Medicare AllowedAmount | 891.32 |
| Total Drug Medicare PaymentAmount | 828.2 |
| Total Drug Medicare Standardized Payment Amount | 828.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 932 |
| Number Of Medicare Beneficiaries With Medical Services | 249 |
| Total Medical Submitted Charge Amount | 84007 |
| Total Medical Medicare Allowed Amount | 38297.14 |
| Total Medical Medicare Payment Amount | 25113.18 |
| Total Medical Medicare Standardized Payment Amount | 27405.84 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 105 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 156 |
| Number Of Male Beneficiaries | 93 |
| Number Of Non Hispanic White Beneficiaries | 198 |
| 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 | 193 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0491 |