National Provider Identifier [NPI]: |
1841221462 |
Last Name Of The Provider |
SIMPSON |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
127 LONE OAK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SEGUIN |
Zip Code Of The Provider |
781557429 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
2069 |
Number Of Medicare Beneficiaries |
360 |
Total Submitted Charge Amount |
176210 |
Total Medicare Allowed Amount |
129793.39 |
Total Medicare Payment Amount |
96386.62 |
Total Medicare Standardized Payment Amount |
121695.02 |
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 |
5 |
Number Of Medical Services |
2069 |
Number Of Medicare Beneficiaries With Medical Services |
360 |
Total Medical Submitted Charge Amount |
176210 |
Total Medical Medicare Allowed Amount |
129793.39 |
Total Medical Medicare Payment Amount |
96386.62 |
Total Medical Medicare Standardized Payment Amount |
121695.02 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
83 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
216 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
162 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
166 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
33 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
327 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
52 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.8657 |