| National Provider Identifier [NPI]: | 1518068402 |
| Last Name Of The Provider | SIMOPOULOS |
| First Name Of The Provider | DEMETRIOS |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 FOWLER WAY |
| Street Address 2 Of The Provider | #5 |
| City Of The Provider | PLACERVILLE |
| Zip Code Of The Provider | 95667 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 9490 |
| Number Of Medicare Beneficiaries | 597 |
| Total Submitted Charge Amount | 374860 |
| Total Medicare Allowed Amount | 219426.26 |
| Total Medicare Payment Amount | 161233.37 |
| Total Medicare Standardized Payment Amount | 159686.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 6862 |
| Number Of Medicare Beneficiaries With Drug Services | 96 |
| Total Drug Submitted ChargeAmount | 157285 |
| Total Drug Medicare AllowedAmount | 66983.95 |
| Total Drug Medicare PaymentAmount | 50850.43 |
| Total Drug Medicare Standardized Payment Amount | 50850.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 2628 |
| Number Of Medicare Beneficiaries With Medical Services | 597 |
| Total Medical Submitted Charge Amount | 217575 |
| Total Medical Medicare Allowed Amount | 152442.31 |
| Total Medical Medicare Payment Amount | 110382.94 |
| Total Medical Medicare Standardized Payment Amount | 108835.71 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 224 |
| Number Of Beneficiaries Age 75 to 84 | 235 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 108 |
| Number Of Male Beneficiaries | 489 |
| Number Of Non Hispanic White Beneficiaries | 564 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 565 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 31 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1197 |