| National Provider Identifier [NPI]: | 1437211232 |
| Last Name Of The Provider | JOHNSON |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1108 1ST ST SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LITTLE FALLS |
| Zip Code Of The Provider | 563453440 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 673 |
| Number Of Medicare Beneficiaries | 130 |
| Total Submitted Charge Amount | 198258 |
| Total Medicare Allowed Amount | 60020.49 |
| Total Medicare Payment Amount | 44957.39 |
| Total Medicare Standardized Payment Amount | 48199.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 410 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 10876 |
| Total Drug Medicare AllowedAmount | 3477.95 |
| Total Drug Medicare PaymentAmount | 2726.77 |
| Total Drug Medicare Standardized Payment Amount | 2726.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 263 |
| Number Of Medicare Beneficiaries With Medical Services | 130 |
| Total Medical Submitted Charge Amount | 187382 |
| Total Medical Medicare Allowed Amount | 56542.54 |
| Total Medical Medicare Payment Amount | 42230.62 |
| Total Medical Medicare Standardized Payment Amount | 45472.7 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 42 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 74 |
| Number Of Male Beneficiaries | 56 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 98 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9338 |