National Provider Identifier [NPI]: |
1922093475 |
Last Name Of The Provider |
BISSELL |
First Name Of The Provider |
MARION |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6355 WALKER LN |
Street Address 2 Of The Provider |
#408 |
City Of The Provider |
ALEXANDRIA |
Zip Code Of The Provider |
223103245 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
276 |
Number Of Medicare Beneficiaries |
227 |
Total Submitted Charge Amount |
70353 |
Total Medicare Allowed Amount |
37886.28 |
Total Medicare Payment Amount |
29528.01 |
Total Medicare Standardized Payment Amount |
26934.63 |
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 |
23 |
Number Of Medical Services |
276 |
Number Of Medicare Beneficiaries With Medical Services |
227 |
Total Medical Submitted Charge Amount |
70353 |
Total Medical Medicare Allowed Amount |
37886.28 |
Total Medical Medicare Payment Amount |
29528.01 |
Total Medical Medicare Standardized Payment Amount |
26934.63 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
152 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
227 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
207 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
7 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
6 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6616 |