| National Provider Identifier [NPI]: | 1255336459 |
| Last Name Of The Provider | SHIMEK |
| First Name Of The Provider | JOCELYN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2380 SOUTHEAST BLVD |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | SALEM |
| Zip Code Of The Provider | 444603476 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 2706 |
| Number Of Medicare Beneficiaries | 432 |
| Total Submitted Charge Amount | 232390.7 |
| Total Medicare Allowed Amount | 185809.59 |
| Total Medicare Payment Amount | 135433.6 |
| Total Medicare Standardized Payment Amount | 140943.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 247 |
| Number Of Medicare Beneficiaries With Drug Services | 171 |
| Total Drug Submitted ChargeAmount | 8121 |
| Total Drug Medicare AllowedAmount | 6228.16 |
| Total Drug Medicare PaymentAmount | 6059.13 |
| Total Drug Medicare Standardized Payment Amount | 6059.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 2459 |
| Number Of Medicare Beneficiaries With Medical Services | 432 |
| Total Medical Submitted Charge Amount | 224269.7 |
| Total Medical Medicare Allowed Amount | 179581.43 |
| Total Medical Medicare Payment Amount | 129374.47 |
| Total Medical Medicare Standardized Payment Amount | 134884.66 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 149 |
| Number Of Beneficiaries Age 75 to 84 | 131 |
| Number Of Beneficiaries Age Greater 84 | 104 |
| Number Of Female Beneficiaries | 287 |
| Number Of Male Beneficiaries | 145 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 347 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.577 |