| National Provider Identifier [NPI]: | 1568415230 |
| Last Name Of The Provider | HISE |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3500 GASTON AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 75246 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 2120 |
| Number Of Medicare Beneficiaries | 1219 |
| Total Submitted Charge Amount | 607139.32 |
| Total Medicare Allowed Amount | 140880.03 |
| Total Medicare Payment Amount | 108484.73 |
| Total Medicare Standardized Payment Amount | 111181.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 376 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 3740.68 |
| Total Drug Medicare AllowedAmount | 487.18 |
| Total Drug Medicare PaymentAmount | 381.99 |
| Total Drug Medicare Standardized Payment Amount | 381.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 1744 |
| Number Of Medicare Beneficiaries With Medical Services | 1219 |
| Total Medical Submitted Charge Amount | 603398.64 |
| Total Medical Medicare Allowed Amount | 140392.85 |
| Total Medical Medicare Payment Amount | 108102.74 |
| Total Medical Medicare Standardized Payment Amount | 110799.64 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 213 |
| Number Of Beneficiaries Age 65 to 74 | 505 |
| Number Of Beneficiaries Age 75 to 84 | 327 |
| Number Of Beneficiaries Age Greater 84 | 174 |
| Number Of Female Beneficiaries | 687 |
| Number Of Male Beneficiaries | 532 |
| Number Of Non Hispanic White Beneficiaries | 840 |
| Number Of Black or African American Beneficiaries | 246 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 101 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 900 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 319 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 27 |
| Average HCC Risk Score Of Beneficiaries | 1.847 |