| National Provider Identifier [NPI]: | 1205836764 |
| Last Name Of The Provider | KALISH |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 830 S GLOSTER ST |
| Street Address 2 Of The Provider | 4TH FLOOR EAST TOWER |
| City Of The Provider | TUPELO |
| Zip Code Of The Provider | 388014934 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 136 |
| Number Of Services | 18067 |
| Number Of Medicare Beneficiaries | 1085 |
| Total Submitted Charge Amount | 1533918.5 |
| Total Medicare Allowed Amount | 445978.33 |
| Total Medicare Payment Amount | 335999.97 |
| Total Medicare Standardized Payment Amount | 367130.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 11205 |
| Number Of Medicare Beneficiaries With Drug Services | 159 |
| Total Drug Submitted ChargeAmount | 104369 |
| Total Drug Medicare AllowedAmount | 39836.93 |
| Total Drug Medicare PaymentAmount | 30888.3 |
| Total Drug Medicare Standardized Payment Amount | 30888.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 125 |
| Number Of Medical Services | 6862 |
| Number Of Medicare Beneficiaries With Medical Services | 1085 |
| Total Medical Submitted Charge Amount | 1429549.5 |
| Total Medical Medicare Allowed Amount | 406141.4 |
| Total Medical Medicare Payment Amount | 305111.67 |
| Total Medical Medicare Standardized Payment Amount | 336242.28 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 162 |
| Number Of Beneficiaries Age 65 to 74 | 445 |
| Number Of Beneficiaries Age 75 to 84 | 378 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 370 |
| Number Of Male Beneficiaries | 715 |
| Number Of Non Hispanic White Beneficiaries | 928 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 864 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 221 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.119 |