National Provider Identifier [NPI]: |
1649233610 |
Last Name Of The Provider |
SIMMONS |
First Name Of The Provider |
SHARONELLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3301 N MILLER RD STE 180 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SCOTTSDALE |
Zip Code Of The Provider |
852516490 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
605 |
Number Of Medicare Beneficiaries |
254 |
Total Submitted Charge Amount |
75765 |
Total Medicare Allowed Amount |
51222.01 |
Total Medicare Payment Amount |
39227.56 |
Total Medicare Standardized Payment Amount |
39527.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
42 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
725 |
Total Drug Medicare AllowedAmount |
194.32 |
Total Drug Medicare PaymentAmount |
153.71 |
Total Drug Medicare Standardized Payment Amount |
153.71 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
563 |
Number Of Medicare Beneficiaries With Medical Services |
254 |
Total Medical Submitted Charge Amount |
75040 |
Total Medical Medicare Allowed Amount |
51027.69 |
Total Medical Medicare Payment Amount |
39073.85 |
Total Medical Medicare Standardized Payment Amount |
39373.81 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
105 |
Number Of Beneficiaries Age 75 to 84 |
88 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
194 |
Number Of Male Beneficiaries |
60 |
Number Of Non Hispanic White Beneficiaries |
242 |
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 |
9 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
7 |
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8051 |