| National Provider Identifier [NPI]: | 1053380774 |
| Last Name Of The Provider | MARTIN-SIMMERMAN |
| First Name Of The Provider | PHYLLIS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 253 SAGAMORE PKWY W |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST LAFAYETTE |
| Zip Code Of The Provider | 479061501 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 177 |
| Number Of Services | 16802 |
| Number Of Medicare Beneficiaries | 4305 |
| Total Submitted Charge Amount | 2118482.25 |
| Total Medicare Allowed Amount | 511423.07 |
| Total Medicare Payment Amount | 411582.24 |
| Total Medicare Standardized Payment Amount | 443073.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 8806 |
| Number Of Medicare Beneficiaries With Drug Services | 181 |
| Total Drug Submitted ChargeAmount | 18092 |
| Total Drug Medicare AllowedAmount | 2847.04 |
| Total Drug Medicare PaymentAmount | 2192.96 |
| Total Drug Medicare Standardized Payment Amount | 2192.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 171 |
| Number Of Medical Services | 7996 |
| Number Of Medicare Beneficiaries With Medical Services | 4305 |
| Total Medical Submitted Charge Amount | 2100390.25 |
| Total Medical Medicare Allowed Amount | 508576.03 |
| Total Medical Medicare Payment Amount | 409389.28 |
| Total Medical Medicare Standardized Payment Amount | 440880.12 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 677 |
| Number Of Beneficiaries Age 65 to 74 | 1834 |
| Number Of Beneficiaries Age 75 to 84 | 1197 |
| Number Of Beneficiaries Age Greater 84 | 597 |
| Number Of Female Beneficiaries | 2985 |
| Number Of Male Beneficiaries | 1320 |
| Number Of Non Hispanic White Beneficiaries | 4148 |
| Number Of Black or African American Beneficiaries | 45 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3365 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 940 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3716 |