| National Provider Identifier [NPI]: | 1699717181 |
| Last Name Of The Provider | SISSON |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3810 GRANT AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOVELAND |
| Zip Code Of The Provider | 805388412 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 15206 |
| Number Of Medicare Beneficiaries | 875 |
| Total Submitted Charge Amount | 2711159.35 |
| Total Medicare Allowed Amount | 700192.06 |
| Total Medicare Payment Amount | 525372.87 |
| Total Medicare Standardized Payment Amount | 517446.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 7701 |
| Number Of Medicare Beneficiaries With Drug Services | 365 |
| Total Drug Submitted ChargeAmount | 128403.35 |
| Total Drug Medicare AllowedAmount | 37755.84 |
| Total Drug Medicare PaymentAmount | 28015.54 |
| Total Drug Medicare Standardized Payment Amount | 28015.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 7505 |
| Number Of Medicare Beneficiaries With Medical Services | 875 |
| Total Medical Submitted Charge Amount | 2582756 |
| Total Medical Medicare Allowed Amount | 662436.22 |
| Total Medical Medicare Payment Amount | 497357.33 |
| Total Medical Medicare Standardized Payment Amount | 489431.17 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 382 |
| Number Of Beneficiaries Age 65 to 74 | 257 |
| Number Of Beneficiaries Age 75 to 84 | 153 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 534 |
| Number Of Male Beneficiaries | 341 |
| Number Of Non Hispanic White Beneficiaries | 736 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 110 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 590 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 285 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2502 |