National Provider Identifier [NPI]: |
1255767588 |
Last Name Of The Provider |
SIMMONS |
First Name Of The Provider |
CHAD |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3330 MASONIC DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALEXANDRIA |
Zip Code Of The Provider |
713013841 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
277 |
Number Of Medicare Beneficiaries |
59 |
Total Submitted Charge Amount |
54173 |
Total Medicare Allowed Amount |
17513.4 |
Total Medicare Payment Amount |
13731.1 |
Total Medicare Standardized Payment Amount |
14792.8 |
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 |
22 |
Number Of Medical Services |
277 |
Number Of Medicare Beneficiaries With Medical Services |
59 |
Total Medical Submitted Charge Amount |
54173 |
Total Medical Medicare Allowed Amount |
17513.4 |
Total Medical Medicare Payment Amount |
13731.1 |
Total Medical Medicare Standardized Payment Amount |
14792.8 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
17 |
Number Of Beneficiaries Age 75 to 84 |
23 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
36 |
Number Of Male Beneficiaries |
23 |
Number Of Non Hispanic White Beneficiaries |
33 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
21 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
56 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
61 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
68 |
Percent Of With Schizophrenia Other PsychoticDisorders |
32 |
Percent Of With Stroke |
27 |
Average HCC Risk Score Of Beneficiaries |
2.9633 |