National Provider Identifier [NPI]: |
1396708376 |
Last Name Of The Provider |
SIMS |
First Name Of The Provider |
REBECCA |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
OD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1515 9TH AVE N |
Street Address 2 Of The Provider |
|
City Of The Provider |
ST PETERSBURG |
Zip Code Of The Provider |
33705 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
1358 |
Number Of Medicare Beneficiaries |
555 |
Total Submitted Charge Amount |
217069 |
Total Medicare Allowed Amount |
127405.2 |
Total Medicare Payment Amount |
92747.68 |
Total Medicare Standardized Payment Amount |
93873.81 |
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 |
27 |
Number Of Medical Services |
1358 |
Number Of Medicare Beneficiaries With Medical Services |
555 |
Total Medical Submitted Charge Amount |
217069 |
Total Medical Medicare Allowed Amount |
127405.2 |
Total Medical Medicare Payment Amount |
92747.68 |
Total Medical Medicare Standardized Payment Amount |
93873.81 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
245 |
Number Of Beneficiaries Age 75 to 84 |
196 |
Number Of Beneficiaries Age Greater 84 |
80 |
Number Of Female Beneficiaries |
356 |
Number Of Male Beneficiaries |
199 |
Number Of Non Hispanic White Beneficiaries |
490 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
38 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
495 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1284 |