| National Provider Identifier [NPI]: | 1639159676 |
| Last Name Of The Provider | SIMON |
| First Name Of The Provider | SYLVIA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 906 ROBERTS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MONTICELLO |
| Zip Code Of The Provider | 716555724 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 5597 |
| Number Of Medicare Beneficiaries | 530 |
| Total Submitted Charge Amount | 338684 |
| Total Medicare Allowed Amount | 203126.84 |
| Total Medicare Payment Amount | 145138.05 |
| Total Medicare Standardized Payment Amount | 158829.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 1908 |
| Number Of Medicare Beneficiaries With Drug Services | 160 |
| Total Drug Submitted ChargeAmount | 40890 |
| Total Drug Medicare AllowedAmount | 28607.87 |
| Total Drug Medicare PaymentAmount | 22539.02 |
| Total Drug Medicare Standardized Payment Amount | 22539.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 3689 |
| Number Of Medicare Beneficiaries With Medical Services | 530 |
| Total Medical Submitted Charge Amount | 297794 |
| Total Medical Medicare Allowed Amount | 174518.97 |
| Total Medical Medicare Payment Amount | 122599.03 |
| Total Medical Medicare Standardized Payment Amount | 136290.79 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 214 |
| Number Of Beneficiaries Age 75 to 84 | 163 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 434 |
| Number Of Male Beneficiaries | 96 |
| Number Of Non Hispanic White Beneficiaries | 434 |
| 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 | 386 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 144 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1719 |