| National Provider Identifier [NPI]: | 1457459133 |
| Last Name Of The Provider | SIMONSEN |
| First Name Of The Provider | STEVEN |
| 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 | 340 MONTAUK HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST ISLIP |
| Zip Code Of The Provider | 117954437 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 943 |
| Number Of Medicare Beneficiaries | 235 |
| Total Submitted Charge Amount | 74071.07 |
| Total Medicare Allowed Amount | 63821.79 |
| Total Medicare Payment Amount | 46745.36 |
| Total Medicare Standardized Payment Amount | 40899.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 271 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 6131.85 |
| Total Drug Medicare AllowedAmount | 796.61 |
| Total Drug Medicare PaymentAmount | 615.33 |
| Total Drug Medicare Standardized Payment Amount | 615.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 672 |
| Number Of Medicare Beneficiaries With Medical Services | 235 |
| Total Medical Submitted Charge Amount | 67939.22 |
| Total Medical Medicare Allowed Amount | 63025.18 |
| Total Medical Medicare Payment Amount | 46130.03 |
| Total Medical Medicare Standardized Payment Amount | 40284.26 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 99 |
| Number Of Beneficiaries Age 75 to 84 | 70 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 148 |
| Number Of Male Beneficiaries | 87 |
| Number Of Non Hispanic White Beneficiaries | 206 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 213 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1654 |