| National Provider Identifier [NPI]: | 1275613523 |
| Last Name Of The Provider | WHITNEY |
| First Name Of The Provider | SIMON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3701 KIRBY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770983900 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 435 |
| Number Of Medicare Beneficiaries | 179 |
| Total Submitted Charge Amount | 87692 |
| Total Medicare Allowed Amount | 36206.86 |
| Total Medicare Payment Amount | 26168.6 |
| Total Medicare Standardized Payment Amount | 26436.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 1204 |
| Total Drug Medicare AllowedAmount | 1098.67 |
| Total Drug Medicare PaymentAmount | 1074.33 |
| Total Drug Medicare Standardized Payment Amount | 1074.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 395 |
| Number Of Medicare Beneficiaries With Medical Services | 178 |
| Total Medical Submitted Charge Amount | 86488 |
| Total Medical Medicare Allowed Amount | 35108.19 |
| Total Medical Medicare Payment Amount | 25094.27 |
| Total Medical Medicare Standardized Payment Amount | 25361.97 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 97 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 86 |
| Number Of Male Beneficiaries | 93 |
| Number Of Non Hispanic White Beneficiaries | 133 |
| Number Of Black or African American Beneficiaries | 23 |
| 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 | 168 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 7 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.902 |