| National Provider Identifier [NPI]: | 1659315158 |
| Last Name Of The Provider | KISER |
| First Name Of The Provider | JACKSON |
| 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 | 1906 BELLEVIEW AVE SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROANOKE |
| Zip Code Of The Provider | 240141838 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 200 |
| Number Of Services | 12894 |
| Number Of Medicare Beneficiaries | 6650 |
| Total Submitted Charge Amount | 1291549.26 |
| Total Medicare Allowed Amount | 375777.58 |
| Total Medicare Payment Amount | 285377.98 |
| Total Medicare Standardized Payment Amount | 293405.94 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 1012 |
| Number Of Beneficiaries Age 65 to 74 | 2418 |
| Number Of Beneficiaries Age 75 to 84 | 2058 |
| Number Of Beneficiaries Age Greater 84 | 1162 |
| Number Of Female Beneficiaries | 4004 |
| Number Of Male Beneficiaries | 2646 |
| Number Of Non Hispanic White Beneficiaries | 6002 |
| Number Of Black or African American Beneficiaries | 551 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 48 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5410 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1240 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4758 |