| National Provider Identifier [NPI]: | 1932346178 |
| Last Name Of The Provider | SIMON |
| First Name Of The Provider | SAJI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 211 KING OF PRUSSIA RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WAYNE |
| Zip Code Of The Provider | 190872103 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 5426 |
| Number Of Medicare Beneficiaries | 909 |
| Total Submitted Charge Amount | 438486 |
| Total Medicare Allowed Amount | 272018.44 |
| Total Medicare Payment Amount | 195772.22 |
| Total Medicare Standardized Payment Amount | 187004.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 5426 |
| Number Of Medicare Beneficiaries With Medical Services | 909 |
| Total Medical Submitted Charge Amount | 438486 |
| Total Medical Medicare Allowed Amount | 272018.44 |
| Total Medical Medicare Payment Amount | 195772.22 |
| Total Medical Medicare Standardized Payment Amount | 187004.53 |
| Average Age Of Beneficiaries | 84 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 107 |
| Number Of Beneficiaries Age 75 to 84 | 229 |
| Number Of Beneficiaries Age Greater 84 | 537 |
| Number Of Female Beneficiaries | 628 |
| Number Of Male Beneficiaries | 281 |
| Number Of Non Hispanic White Beneficiaries | 793 |
| Number Of Black or African American Beneficiaries | 88 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 573 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 336 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 65 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.0729 |