| National Provider Identifier [NPI]: | 1497866065 |
| Last Name Of The Provider | MORRIS-CHRISTIAN |
| First Name Of The Provider | TISA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D.,MPH |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 640 BANKVIEW DR |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | FRANKFORT |
| Zip Code Of The Provider | 604231383 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 162 |
| Number Of Medicare Beneficiaries | 33 |
| Total Submitted Charge Amount | 19389.5 |
| Total Medicare Allowed Amount | 10721.25 |
| Total Medicare Payment Amount | 7470.68 |
| Total Medicare Standardized Payment Amount | 7137.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 19 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 404.5 |
| Total Drug Medicare AllowedAmount | 211.68 |
| Total Drug Medicare PaymentAmount | 206.49 |
| Total Drug Medicare Standardized Payment Amount | 206.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 143 |
| Number Of Medicare Beneficiaries With Medical Services | 33 |
| Total Medical Submitted Charge Amount | 18985 |
| Total Medical Medicare Allowed Amount | 10509.57 |
| Total Medical Medicare Payment Amount | 7264.19 |
| Total Medical Medicare Standardized Payment Amount | 6930.86 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 16 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 22 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 21 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 0 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0176 |