| National Provider Identifier [NPI]: | 1013124395 |
| Last Name Of The Provider | AYALA-SIMS |
| First Name Of The Provider | VERONICA |
| 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 | 1250 E MARSHALL ST |
| Street Address 2 Of The Provider | INTERNAL MEDICINE |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232985051 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pediatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 334 |
| Number Of Medicare Beneficiaries | 107 |
| Total Submitted Charge Amount | 75235 |
| Total Medicare Allowed Amount | 27990.68 |
| Total Medicare Payment Amount | 20979.45 |
| Total Medicare Standardized Payment Amount | 21455.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 14 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 502 |
| Total Drug Medicare AllowedAmount | 353.32 |
| Total Drug Medicare PaymentAmount | 346.25 |
| Total Drug Medicare Standardized Payment Amount | 346.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 320 |
| Number Of Medicare Beneficiaries With Medical Services | 104 |
| Total Medical Submitted Charge Amount | 74733 |
| Total Medical Medicare Allowed Amount | 27637.36 |
| Total Medical Medicare Payment Amount | 20633.2 |
| Total Medical Medicare Standardized Payment Amount | 21109.63 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 24 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 44 |
| Number Of Male Beneficiaries | 63 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 75 |
| 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 | 43 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.9296 |