National Provider Identifier [NPI]: |
1780663963 |
Last Name Of The Provider |
SIMPSON |
First Name Of The Provider |
KAREEN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9730 S WESTERN AVE |
Street Address 2 Of The Provider |
SUITE 326 |
City Of The Provider |
EVERGREEN PARK |
Zip Code Of The Provider |
608052814 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
7914 |
Number Of Medicare Beneficiaries |
705 |
Total Submitted Charge Amount |
1053341.5 |
Total Medicare Allowed Amount |
527921.87 |
Total Medicare Payment Amount |
405956.72 |
Total Medicare Standardized Payment Amount |
380667.12 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
203 |
Number Of Beneficiaries Age 65 to 74 |
215 |
Number Of Beneficiaries Age 75 to 84 |
201 |
Number Of Beneficiaries Age Greater 84 |
86 |
Number Of Female Beneficiaries |
384 |
Number Of Male Beneficiaries |
321 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
615 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
49 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
313 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
392 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
21 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
74 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
5.9033 |