| National Provider Identifier [NPI]: | 1447259171 |
| Last Name Of The Provider | SIMON |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 75 PRINTERS PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLORADO SPRINGS |
| Zip Code Of The Provider | 809103151 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 3388 |
| Number Of Medicare Beneficiaries | 683 |
| Total Submitted Charge Amount | 584474.95 |
| Total Medicare Allowed Amount | 315225.94 |
| Total Medicare Payment Amount | 237450.41 |
| Total Medicare Standardized Payment Amount | 238367.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 1113 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 186790.72 |
| Total Drug Medicare AllowedAmount | 109672.92 |
| Total Drug Medicare PaymentAmount | 85598.3 |
| Total Drug Medicare Standardized Payment Amount | 85598.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 2275 |
| Number Of Medicare Beneficiaries With Medical Services | 683 |
| Total Medical Submitted Charge Amount | 397684.23 |
| Total Medical Medicare Allowed Amount | 205553.02 |
| Total Medical Medicare Payment Amount | 151852.11 |
| Total Medical Medicare Standardized Payment Amount | 152768.83 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 267 |
| Number Of Beneficiaries Age 75 to 84 | 267 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 155 |
| Number Of Male Beneficiaries | 528 |
| Number Of Non Hispanic White Beneficiaries | 608 |
| Number Of Black or African American Beneficiaries | 31 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 627 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 32 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1746 |