| National Provider Identifier [NPI]: | 1851400410 |
| Last Name Of The Provider | SIMNICHT |
| First Name Of The Provider | KEITH |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 50 PARKWAY LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | PETAL |
| Zip Code Of The Provider | 394653035 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 2640 |
| Number Of Medicare Beneficiaries | 533 |
| Total Submitted Charge Amount | 159202 |
| Total Medicare Allowed Amount | 94046.71 |
| Total Medicare Payment Amount | 62484.69 |
| Total Medicare Standardized Payment Amount | 69981.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 584 |
| Number Of Medicare Beneficiaries With Drug Services | 196 |
| Total Drug Submitted ChargeAmount | 8892 |
| Total Drug Medicare AllowedAmount | 2943.12 |
| Total Drug Medicare PaymentAmount | 2470.06 |
| Total Drug Medicare Standardized Payment Amount | 2470.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 2056 |
| Number Of Medicare Beneficiaries With Medical Services | 533 |
| Total Medical Submitted Charge Amount | 150310 |
| Total Medical Medicare Allowed Amount | 91103.59 |
| Total Medical Medicare Payment Amount | 60014.63 |
| Total Medical Medicare Standardized Payment Amount | 67511.8 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 253 |
| Number Of Beneficiaries Age 75 to 84 | 139 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 328 |
| Number Of Male Beneficiaries | 205 |
| Number Of Non Hispanic White Beneficiaries | 461 |
| 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 | 408 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 125 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9543 |