National Provider Identifier [NPI]: |
1912985276 |
Last Name Of The Provider |
SIM |
First Name Of The Provider |
JULIE |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 WESTAGE BUSINESS CTR DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
FISHKILL |
Zip Code Of The Provider |
125242281 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
416 |
Number Of Medicare Beneficiaries |
87 |
Total Submitted Charge Amount |
48324.6 |
Total Medicare Allowed Amount |
24038.6 |
Total Medicare Payment Amount |
17517.55 |
Total Medicare Standardized Payment Amount |
17702.51 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
84 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
12473.2 |
Total Drug Medicare AllowedAmount |
5639.04 |
Total Drug Medicare PaymentAmount |
4983.65 |
Total Drug Medicare Standardized Payment Amount |
4983.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
23 |
Number Of Medical Services |
332 |
Number Of Medicare Beneficiaries With Medical Services |
87 |
Total Medical Submitted Charge Amount |
35851.4 |
Total Medical Medicare Allowed Amount |
18399.56 |
Total Medical Medicare Payment Amount |
12533.9 |
Total Medical Medicare Standardized Payment Amount |
12718.86 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
65 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
50 |
Number Of Male Beneficiaries |
37 |
Number Of Non Hispanic White Beneficiaries |
57 |
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 |
87 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
0 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
17 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
16 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7375 |