| National Provider Identifier [NPI]: | 1659309631 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | DEANNA |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2312 N NEVADA AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | COLORADO SPRINGS |
| Zip Code Of The Provider | 809075302 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 8484 |
| Number Of Medicare Beneficiaries | 245 |
| Total Submitted Charge Amount | 248499 |
| Total Medicare Allowed Amount | 88371.66 |
| Total Medicare Payment Amount | 57495.93 |
| Total Medicare Standardized Payment Amount | 65555.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 7900 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 115700 |
| Total Drug Medicare AllowedAmount | 43129.22 |
| Total Drug Medicare PaymentAmount | 25693.21 |
| Total Drug Medicare Standardized Payment Amount | 25693.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 584 |
| Number Of Medicare Beneficiaries With Medical Services | 245 |
| Total Medical Submitted Charge Amount | 132799 |
| Total Medical Medicare Allowed Amount | 45242.44 |
| Total Medical Medicare Payment Amount | 31802.72 |
| Total Medical Medicare Standardized Payment Amount | 39862.57 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 60 |
| Number Of Beneficiaries Age 75 to 84 | 67 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 151 |
| Number Of Male Beneficiaries | 94 |
| Number Of Non Hispanic White Beneficiaries | 208 |
| Number Of Black or African American Beneficiaries | 15 |
| 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 | 188 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2196 |