National Provider Identifier [NPI]: |
1790714590 |
Last Name Of The Provider |
BISSON |
First Name Of The Provider |
ALBERT |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4120 W MEMORIAL RD STE 118 |
Street Address 2 Of The Provider |
|
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731209322 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
3226 |
Number Of Medicare Beneficiaries |
609 |
Total Submitted Charge Amount |
292942 |
Total Medicare Allowed Amount |
179604.34 |
Total Medicare Payment Amount |
136843.98 |
Total Medicare Standardized Payment Amount |
145063.99 |
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 |
14 |
Number Of Medical Services |
3226 |
Number Of Medicare Beneficiaries With Medical Services |
609 |
Total Medical Submitted Charge Amount |
292942 |
Total Medical Medicare Allowed Amount |
179604.34 |
Total Medical Medicare Payment Amount |
136843.98 |
Total Medical Medicare Standardized Payment Amount |
145063.99 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
230 |
Number Of Beneficiaries Age 75 to 84 |
203 |
Number Of Beneficiaries Age Greater 84 |
122 |
Number Of Female Beneficiaries |
356 |
Number Of Male Beneficiaries |
253 |
Number Of Non Hispanic White Beneficiaries |
540 |
Number Of Black or African American Beneficiaries |
30 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
23 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
529 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
63 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
28 |
Average HCC Risk Score Of Beneficiaries |
1.5463 |