| National Provider Identifier [NPI]: | 1134142896 |
| Last Name Of The Provider | TISONE |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 ABRAHAM FLEXNER WAY |
| Street Address 2 Of The Provider | PATHOLOGY DEPT |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402021818 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 3447 |
| Number Of Medicare Beneficiaries | 1132 |
| Total Submitted Charge Amount | 576648 |
| Total Medicare Allowed Amount | 121718.13 |
| Total Medicare Payment Amount | 94455.81 |
| Total Medicare Standardized Payment Amount | 71814.79 |
| 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 | 33 |
| Number Of Medical Services | 3447 |
| Number Of Medicare Beneficiaries With Medical Services | 1132 |
| Total Medical Submitted Charge Amount | 576648 |
| Total Medical Medicare Allowed Amount | 121718.13 |
| Total Medical Medicare Payment Amount | 94455.81 |
| Total Medical Medicare Standardized Payment Amount | 71814.79 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 285 |
| Number Of Beneficiaries Age 65 to 74 | 488 |
| Number Of Beneficiaries Age 75 to 84 | 272 |
| Number Of Beneficiaries Age Greater 84 | 87 |
| Number Of Female Beneficiaries | 611 |
| Number Of Male Beneficiaries | 521 |
| Number Of Non Hispanic White Beneficiaries | 937 |
| Number Of Black or African American Beneficiaries | 166 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 812 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 320 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.8603 |