National Provider Identifier [NPI]: |
1679550909 |
Last Name Of The Provider |
SIMON |
First Name Of The Provider |
BENJAMIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
18370 BURBANK BLVD |
Street Address 2 Of The Provider |
SUITE 707 |
City Of The Provider |
TARZANA |
Zip Code Of The Provider |
913562804 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
4829 |
Number Of Medicare Beneficiaries |
792 |
Total Submitted Charge Amount |
1814983.32 |
Total Medicare Allowed Amount |
670398.84 |
Total Medicare Payment Amount |
509694.34 |
Total Medicare Standardized Payment Amount |
479331.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
344 |
Number Of Medicare Beneficiaries With Drug Services |
85 |
Total Drug Submitted ChargeAmount |
43000 |
Total Drug Medicare AllowedAmount |
18216.48 |
Total Drug Medicare PaymentAmount |
14115.81 |
Total Drug Medicare Standardized Payment Amount |
14115.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
69 |
Number Of Medical Services |
4485 |
Number Of Medicare Beneficiaries With Medical Services |
791 |
Total Medical Submitted Charge Amount |
1771983.32 |
Total Medical Medicare Allowed Amount |
652182.36 |
Total Medical Medicare Payment Amount |
495578.53 |
Total Medical Medicare Standardized Payment Amount |
465215.6 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
222 |
Number Of Beneficiaries Age 75 to 84 |
306 |
Number Of Beneficiaries Age Greater 84 |
250 |
Number Of Female Beneficiaries |
357 |
Number Of Male Beneficiaries |
435 |
Number Of Non Hispanic White Beneficiaries |
744 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
722 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
70 |
Percent Of With Atrial Fibrillation |
31 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.6009 |