National Provider Identifier [NPI]: |
1306894506 |
Last Name Of The Provider |
SIMMONS |
First Name Of The Provider |
JENNIFER |
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 |
100 N ACADEMY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DANVILLE |
Zip Code Of The Provider |
178221316 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
70 |
Number Of Services |
1316 |
Number Of Medicare Beneficiaries |
384 |
Total Submitted Charge Amount |
430654.8 |
Total Medicare Allowed Amount |
92437.83 |
Total Medicare Payment Amount |
69152.44 |
Total Medicare Standardized Payment Amount |
71612.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
59 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
50400 |
Total Drug Medicare AllowedAmount |
7690.63 |
Total Drug Medicare PaymentAmount |
6009.18 |
Total Drug Medicare Standardized Payment Amount |
6009.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
1257 |
Number Of Medicare Beneficiaries With Medical Services |
384 |
Total Medical Submitted Charge Amount |
380254.8 |
Total Medical Medicare Allowed Amount |
84747.2 |
Total Medical Medicare Payment Amount |
63143.26 |
Total Medical Medicare Standardized Payment Amount |
65603.79 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
166 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
215 |
Number Of Non Hispanic White Beneficiaries |
368 |
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 |
299 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.3514 |