National Provider Identifier [NPI]: |
1003052150 |
Last Name Of The Provider |
RODNEY |
First Name Of The Provider |
SIMI |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1225 W LAKE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MELROSE PARK |
Zip Code Of The Provider |
601604039 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
1826 |
Number Of Medicare Beneficiaries |
485 |
Total Submitted Charge Amount |
451016 |
Total Medicare Allowed Amount |
243150.71 |
Total Medicare Payment Amount |
189715.11 |
Total Medicare Standardized Payment Amount |
180222.28 |
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 |
1826 |
Number Of Medicare Beneficiaries With Medical Services |
485 |
Total Medical Submitted Charge Amount |
451016 |
Total Medical Medicare Allowed Amount |
243150.71 |
Total Medical Medicare Payment Amount |
189715.11 |
Total Medical Medicare Standardized Payment Amount |
180222.28 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
148 |
Number Of Beneficiaries Age 65 to 74 |
122 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
104 |
Number Of Female Beneficiaries |
263 |
Number Of Male Beneficiaries |
222 |
Number Of Non Hispanic White Beneficiaries |
329 |
Number Of Black or African American Beneficiaries |
56 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
86 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
201 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
284 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
40 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
60 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
56 |
Percent Of With Schizophrenia Other PsychoticDisorders |
27 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.7448 |