National Provider Identifier [NPI]: |
1073576344 |
Last Name Of The Provider |
SIMS |
First Name Of The Provider |
CLINTON |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3949 EVANS AVE |
Street Address 2 Of The Provider |
STE 106 |
City Of The Provider |
FORT MYERS |
Zip Code Of The Provider |
339019341 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
752 |
Number Of Medicare Beneficiaries |
389 |
Total Submitted Charge Amount |
95370.06 |
Total Medicare Allowed Amount |
87219.81 |
Total Medicare Payment Amount |
58698.3 |
Total Medicare Standardized Payment Amount |
57209.97 |
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 |
15 |
Number Of Medical Services |
752 |
Number Of Medicare Beneficiaries With Medical Services |
389 |
Total Medical Submitted Charge Amount |
95370.06 |
Total Medical Medicare Allowed Amount |
87219.81 |
Total Medical Medicare Payment Amount |
58698.3 |
Total Medical Medicare Standardized Payment Amount |
57209.97 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
150 |
Number Of Beneficiaries Age Greater 84 |
118 |
Number Of Female Beneficiaries |
234 |
Number Of Male Beneficiaries |
155 |
Number Of Non Hispanic White Beneficiaries |
360 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
368 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1358 |