| National Provider Identifier [NPI]: | 1952300592 |
| Last Name Of The Provider | TISON |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 431 S BATAVIA ST |
| Street Address 2 Of The Provider | STE. 103 |
| City Of The Provider | ORANGE |
| Zip Code Of The Provider | 928683936 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 3502 |
| Number Of Medicare Beneficiaries | 1554 |
| Total Submitted Charge Amount | 427934.82 |
| Total Medicare Allowed Amount | 123202.5 |
| Total Medicare Payment Amount | 90011.68 |
| Total Medicare Standardized Payment Amount | 80095.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 956 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 1687 |
| Total Drug Medicare AllowedAmount | 410.85 |
| Total Drug Medicare PaymentAmount | 322.12 |
| Total Drug Medicare Standardized Payment Amount | 322.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 143 |
| Number Of Medical Services | 2546 |
| Number Of Medicare Beneficiaries With Medical Services | 1554 |
| Total Medical Submitted Charge Amount | 426247.82 |
| Total Medical Medicare Allowed Amount | 122791.65 |
| Total Medical Medicare Payment Amount | 89689.56 |
| Total Medical Medicare Standardized Payment Amount | 79773.33 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 178 |
| Number Of Beneficiaries Age 65 to 74 | 546 |
| Number Of Beneficiaries Age 75 to 84 | 525 |
| Number Of Beneficiaries Age Greater 84 | 305 |
| Number Of Female Beneficiaries | 917 |
| Number Of Male Beneficiaries | 637 |
| Number Of Non Hispanic White Beneficiaries | 1086 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 138 |
| Number Of Hispanic Beneficiaries | 277 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1163 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 391 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8913 |