| National Provider Identifier [NPI]: | 1023280062 |
| Last Name Of The Provider | BISSWANGER |
| First Name Of The Provider | BILLY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4301 W MARKHAM ST |
| Street Address 2 Of The Provider | SLOT 584 |
| City Of The Provider | LITTLE ROCK |
| Zip Code Of The Provider | 722057101 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 1255 |
| Number Of Medicare Beneficiaries | 754 |
| Total Submitted Charge Amount | 490480 |
| Total Medicare Allowed Amount | 118043.66 |
| Total Medicare Payment Amount | 90208.48 |
| Total Medicare Standardized Payment Amount | 95635.45 |
| 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 | 29 |
| Number Of Medical Services | 1255 |
| Number Of Medicare Beneficiaries With Medical Services | 754 |
| Total Medical Submitted Charge Amount | 490480 |
| Total Medical Medicare Allowed Amount | 118043.66 |
| Total Medical Medicare Payment Amount | 90208.48 |
| Total Medical Medicare Standardized Payment Amount | 95635.45 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 194 |
| Number Of Beneficiaries Age 65 to 74 | 198 |
| Number Of Beneficiaries Age 75 to 84 | 235 |
| Number Of Beneficiaries Age Greater 84 | 127 |
| Number Of Female Beneficiaries | 408 |
| Number Of Male Beneficiaries | 346 |
| Number Of Non Hispanic White Beneficiaries | 742 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 500 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 254 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6613 |