National Provider Identifier [NPI]: |
1659309672 |
Last Name Of The Provider |
SIM |
First Name Of The Provider |
PETER |
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 |
1520 SAN PABLO ST |
Street Address 2 Of The Provider |
SUITE 1000 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900335310 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
6476 |
Number Of Medicare Beneficiaries |
706 |
Total Submitted Charge Amount |
899775 |
Total Medicare Allowed Amount |
571590.16 |
Total Medicare Payment Amount |
448057.43 |
Total Medicare Standardized Payment Amount |
304073.41 |
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 |
13 |
Number Of Medical Services |
6476 |
Number Of Medicare Beneficiaries With Medical Services |
706 |
Total Medical Submitted Charge Amount |
899775 |
Total Medical Medicare Allowed Amount |
571590.16 |
Total Medical Medicare Payment Amount |
448057.43 |
Total Medical Medicare Standardized Payment Amount |
304073.41 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
164 |
Number Of Beneficiaries Age 65 to 74 |
194 |
Number Of Beneficiaries Age 75 to 84 |
184 |
Number Of Beneficiaries Age Greater 84 |
164 |
Number Of Female Beneficiaries |
315 |
Number Of Male Beneficiaries |
391 |
Number Of Non Hispanic White Beneficiaries |
257 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
114 |
Number Of Hispanic Beneficiaries |
230 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
72 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
634 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
70 |
Percent Of With Asthma |
20 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
75 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
75 |
Percent Of With Depression |
56 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
57 |
Percent Of With Stroke |
27 |
Average HCC Risk Score Of Beneficiaries |
4.4458 |