National Provider Identifier [NPI]: |
1407837891 |
Last Name Of The Provider |
SIMPSON |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4513 HIXSON PIKE |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
HIXSON |
Zip Code Of The Provider |
373435039 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
67 |
Number Of Services |
1281 |
Number Of Medicare Beneficiaries |
112 |
Total Submitted Charge Amount |
105456 |
Total Medicare Allowed Amount |
61867.58 |
Total Medicare Payment Amount |
43078.77 |
Total Medicare Standardized Payment Amount |
50086.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
358 |
Number Of Medicare Beneficiaries With Drug Services |
56 |
Total Drug Submitted ChargeAmount |
3578 |
Total Drug Medicare AllowedAmount |
886.3 |
Total Drug Medicare PaymentAmount |
636.93 |
Total Drug Medicare Standardized Payment Amount |
636.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
56 |
Number Of Medical Services |
923 |
Number Of Medicare Beneficiaries With Medical Services |
112 |
Total Medical Submitted Charge Amount |
101878 |
Total Medical Medicare Allowed Amount |
60981.28 |
Total Medical Medicare Payment Amount |
42441.84 |
Total Medical Medicare Standardized Payment Amount |
49449.08 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
45 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
54 |
Number Of Male Beneficiaries |
58 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
79 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
33 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
32 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0778 |