National Provider Identifier [NPI]: |
1104931328 |
Last Name Of The Provider |
SIMMONS |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
57 W TIMONIUM RD |
Street Address 2 Of The Provider |
SUITE #208 |
City Of The Provider |
TIMONIUM |
Zip Code Of The Provider |
210933125 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
851 |
Number Of Medicare Beneficiaries |
474 |
Total Submitted Charge Amount |
82558 |
Total Medicare Allowed Amount |
51051.16 |
Total Medicare Payment Amount |
38431.91 |
Total Medicare Standardized Payment Amount |
38018.97 |
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 |
11 |
Number Of Medical Services |
851 |
Number Of Medicare Beneficiaries With Medical Services |
474 |
Total Medical Submitted Charge Amount |
82558 |
Total Medical Medicare Allowed Amount |
51051.16 |
Total Medical Medicare Payment Amount |
38431.91 |
Total Medical Medicare Standardized Payment Amount |
38018.97 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
229 |
Number Of Beneficiaries Age 75 to 84 |
199 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
474 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
455 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
3 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
3 |
Percent Of With Chronic Kidney Disease |
4 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
10 |
Percent Of With Diabetes |
12 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
15 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6781 |