| National Provider Identifier [NPI]: | 1275571028 |
| Last Name Of The Provider | GEISSE |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2290 SACRAMENTO ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | VALLEJO |
| Zip Code Of The Provider | 945902929 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 151 |
| Number Of Services | 13210 |
| Number Of Medicare Beneficiaries | 3891 |
| Total Submitted Charge Amount | 2865161 |
| Total Medicare Allowed Amount | 1823924.76 |
| Total Medicare Payment Amount | 1378908.09 |
| Total Medicare Standardized Payment Amount | 1127690.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 266 |
| Number Of Medicare Beneficiaries With Drug Services | 137 |
| Total Drug Submitted ChargeAmount | 32826 |
| Total Drug Medicare AllowedAmount | 32515.49 |
| Total Drug Medicare PaymentAmount | 25476.16 |
| Total Drug Medicare Standardized Payment Amount | 25476.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 146 |
| Number Of Medical Services | 12944 |
| Number Of Medicare Beneficiaries With Medical Services | 3891 |
| Total Medical Submitted Charge Amount | 2832335 |
| Total Medical Medicare Allowed Amount | 1791409.27 |
| Total Medical Medicare Payment Amount | 1353431.93 |
| Total Medical Medicare Standardized Payment Amount | 1102214.44 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 211 |
| Number Of Beneficiaries Age 65 to 74 | 1728 |
| Number Of Beneficiaries Age 75 to 84 | 1269 |
| Number Of Beneficiaries Age Greater 84 | 683 |
| Number Of Female Beneficiaries | 1949 |
| Number Of Male Beneficiaries | 1942 |
| Number Of Non Hispanic White Beneficiaries | 3557 |
| Number Of Black or African American Beneficiaries | 75 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 107 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 76 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3687 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 204 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.039 |