National Provider Identifier [NPI]: |
1962466391 |
Last Name Of The Provider |
SIMON |
First Name Of The Provider |
ALLISON |
Middle Initial Of The Provider |
I |
Credentials Of The Provider |
APRN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5073 MAIN ST |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
SPRING HILL |
Zip Code Of The Provider |
371742737 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
204 |
Number Of Medicare Beneficiaries |
46 |
Total Submitted Charge Amount |
11092.5 |
Total Medicare Allowed Amount |
6175.36 |
Total Medicare Payment Amount |
4492.88 |
Total Medicare Standardized Payment Amount |
5783.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
28 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
477.5 |
Total Drug Medicare AllowedAmount |
34.68 |
Total Drug Medicare PaymentAmount |
25.52 |
Total Drug Medicare Standardized Payment Amount |
25.52 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
176 |
Number Of Medicare Beneficiaries With Medical Services |
46 |
Total Medical Submitted Charge Amount |
10615 |
Total Medical Medicare Allowed Amount |
6140.68 |
Total Medical Medicare Payment Amount |
4467.36 |
Total Medical Medicare Standardized Payment Amount |
5757.58 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
25 |
Number Of Male Beneficiaries |
21 |
Number Of Non Hispanic White Beneficiaries |
35 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
22 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
24 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
0 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
1.2702 |