| National Provider Identifier [NPI]: | 1194799338 |
| Last Name Of The Provider | BASS |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 406 RIDLEY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAGRANGE |
| Zip Code Of The Provider | 302402232 |
| 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 | 218 |
| Number Of Services | 14703 |
| Number Of Medicare Beneficiaries | 2645 |
| Total Submitted Charge Amount | 826776 |
| Total Medicare Allowed Amount | 223723.51 |
| Total Medicare Payment Amount | 161832.75 |
| Total Medicare Standardized Payment Amount | 175973.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 8705 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 11937 |
| Total Drug Medicare AllowedAmount | 1939.86 |
| Total Drug Medicare PaymentAmount | 1471.16 |
| Total Drug Medicare Standardized Payment Amount | 1471.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 215 |
| Number Of Medical Services | 5998 |
| Number Of Medicare Beneficiaries With Medical Services | 2645 |
| Total Medical Submitted Charge Amount | 814839 |
| Total Medical Medicare Allowed Amount | 221783.65 |
| Total Medical Medicare Payment Amount | 160361.59 |
| Total Medical Medicare Standardized Payment Amount | 174502.01 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 725 |
| Number Of Beneficiaries Age 65 to 74 | 956 |
| Number Of Beneficiaries Age 75 to 84 | 633 |
| Number Of Beneficiaries Age Greater 84 | 331 |
| Number Of Female Beneficiaries | 1846 |
| Number Of Male Beneficiaries | 799 |
| Number Of Non Hispanic White Beneficiaries | 1772 |
| Number Of Black or African American Beneficiaries | 846 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1713 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 932 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3129 |