| National Provider Identifier [NPI]: | 1235341017 |
| Last Name Of The Provider | SIMS |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 203 MEDICAL BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | STOCKBRIDGE |
| Zip Code Of The Provider | 302817218 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 976 |
| Number Of Medicare Beneficiaries | 265 |
| Total Submitted Charge Amount | 112051.75 |
| Total Medicare Allowed Amount | 41175.17 |
| Total Medicare Payment Amount | 30557.77 |
| Total Medicare Standardized Payment Amount | 36807.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 159 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 8333 |
| Total Drug Medicare AllowedAmount | 3454.86 |
| Total Drug Medicare PaymentAmount | 2690.99 |
| Total Drug Medicare Standardized Payment Amount | 2690.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 817 |
| Number Of Medicare Beneficiaries With Medical Services | 265 |
| Total Medical Submitted Charge Amount | 103718.75 |
| Total Medical Medicare Allowed Amount | 37720.31 |
| Total Medical Medicare Payment Amount | 27866.78 |
| Total Medical Medicare Standardized Payment Amount | 34116.14 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 116 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 164 |
| Number Of Male Beneficiaries | 101 |
| Number Of Non Hispanic White Beneficiaries | 218 |
| 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 | 212 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9914 |