National Provider Identifier [NPI]: |
1508832924 |
Last Name Of The Provider |
SHIMER |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2770 3RD AVE STE 120 |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKE CHARLES |
Zip Code Of The Provider |
706018994 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
95 |
Number Of Services |
480 |
Number Of Medicare Beneficiaries |
234 |
Total Submitted Charge Amount |
409862.25 |
Total Medicare Allowed Amount |
149062.65 |
Total Medicare Payment Amount |
112323.63 |
Total Medicare Standardized Payment Amount |
122048.79 |
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 |
95 |
Number Of Medical Services |
480 |
Number Of Medicare Beneficiaries With Medical Services |
234 |
Total Medical Submitted Charge Amount |
409862.25 |
Total Medical Medicare Allowed Amount |
149062.65 |
Total Medical Medicare Payment Amount |
112323.63 |
Total Medical Medicare Standardized Payment Amount |
122048.79 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
125 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
169 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
157 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
77 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.6891 |