| National Provider Identifier [NPI]: | 1568442887 |
| Last Name Of The Provider | SIMONS |
| First Name Of The Provider | GARRY |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 770 PINE ST STE 290 |
| Street Address 2 Of The Provider | ATTN: RADIOLOGY DEPARTMENT |
| City Of The Provider | MACON |
| Zip Code Of The Provider | 312017516 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 192 |
| Number Of Services | 7094 |
| Number Of Medicare Beneficiaries | 3762 |
| Total Submitted Charge Amount | 735971 |
| Total Medicare Allowed Amount | 175564.06 |
| Total Medicare Payment Amount | 131741.47 |
| Total Medicare Standardized Payment Amount | 140341.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1868 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 8133 |
| Total Drug Medicare AllowedAmount | 729.1 |
| Total Drug Medicare PaymentAmount | 571.61 |
| Total Drug Medicare Standardized Payment Amount | 571.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 188 |
| Number Of Medical Services | 5226 |
| Number Of Medicare Beneficiaries With Medical Services | 3761 |
| Total Medical Submitted Charge Amount | 727838 |
| Total Medical Medicare Allowed Amount | 174834.96 |
| Total Medical Medicare Payment Amount | 131169.86 |
| Total Medical Medicare Standardized Payment Amount | 139770.07 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 839 |
| Number Of Beneficiaries Age 65 to 74 | 1400 |
| Number Of Beneficiaries Age 75 to 84 | 1070 |
| Number Of Beneficiaries Age Greater 84 | 453 |
| Number Of Female Beneficiaries | 2009 |
| Number Of Male Beneficiaries | 1753 |
| Number Of Non Hispanic White Beneficiaries | 2574 |
| Number Of Black or African American Beneficiaries | 1134 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2668 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1094 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.9536 |