| National Provider Identifier [NPI]: | 1336149988 |
| Last Name Of The Provider | BISE |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1061 HARMON AVE |
| Street Address 2 Of The Provider | SUITE 2J11D |
| City Of The Provider | FT STEWART |
| Zip Code Of The Provider | 313145604 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 151 |
| Number Of Services | 4447 |
| Number Of Medicare Beneficiaries | 2970 |
| Total Submitted Charge Amount | 373446 |
| Total Medicare Allowed Amount | 104745.91 |
| Total Medicare Payment Amount | 82578.75 |
| Total Medicare Standardized Payment Amount | 85673.62 |
| 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 | 151 |
| Number Of Medical Services | 4447 |
| Number Of Medicare Beneficiaries With Medical Services | 2970 |
| Total Medical Submitted Charge Amount | 373446 |
| Total Medical Medicare Allowed Amount | 104745.91 |
| Total Medical Medicare Payment Amount | 82578.75 |
| Total Medical Medicare Standardized Payment Amount | 85673.62 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 682 |
| Number Of Beneficiaries Age 65 to 74 | 1062 |
| Number Of Beneficiaries Age 75 to 84 | 801 |
| Number Of Beneficiaries Age Greater 84 | 425 |
| Number Of Female Beneficiaries | 1840 |
| Number Of Male Beneficiaries | 1130 |
| Number Of Non Hispanic White Beneficiaries | 1712 |
| Number Of Black or African American Beneficiaries | 1216 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1811 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1159 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7774 |