| National Provider Identifier [NPI]: | 1588645295 |
| Last Name Of The Provider | BISESE |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2525 DESALES AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 37404 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 292 |
| Number Of Services | 10911 |
| Number Of Medicare Beneficiaries | 6016 |
| Total Submitted Charge Amount | 1500659 |
| Total Medicare Allowed Amount | 482680.58 |
| Total Medicare Payment Amount | 365070.92 |
| Total Medicare Standardized Payment Amount | 392662.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 292 |
| Number Of Medical Services | 10911 |
| Number Of Medicare Beneficiaries With Medical Services | 6016 |
| Total Medical Submitted Charge Amount | 1500659 |
| Total Medical Medicare Allowed Amount | 482680.58 |
| Total Medical Medicare Payment Amount | 365070.92 |
| Total Medical Medicare Standardized Payment Amount | 392662.83 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 1003 |
| Number Of Beneficiaries Age 65 to 74 | 2061 |
| Number Of Beneficiaries Age 75 to 84 | 1908 |
| Number Of Beneficiaries Age Greater 84 | 1044 |
| Number Of Female Beneficiaries | 3487 |
| Number Of Male Beneficiaries | 2529 |
| Number Of Non Hispanic White Beneficiaries | 5323 |
| Number Of Black or African American Beneficiaries | 613 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4640 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1376 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8049 |