| National Provider Identifier [NPI]: | 1851467781 |
| Last Name Of The Provider | SIMONDS |
| First Name Of The Provider | JUSTIN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1600 PHILLIPS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TALLAHASSEE |
| Zip Code Of The Provider | 323085304 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 4348 |
| Number Of Medicare Beneficiaries | 2568 |
| Total Submitted Charge Amount | 661113 |
| Total Medicare Allowed Amount | 201994.96 |
| Total Medicare Payment Amount | 147968.49 |
| Total Medicare Standardized Payment Amount | 144472.8 |
| 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 | 119 |
| Number Of Medical Services | 4348 |
| Number Of Medicare Beneficiaries With Medical Services | 2568 |
| Total Medical Submitted Charge Amount | 661113 |
| Total Medical Medicare Allowed Amount | 201994.96 |
| Total Medical Medicare Payment Amount | 147968.49 |
| Total Medical Medicare Standardized Payment Amount | 144472.8 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 661 |
| Number Of Beneficiaries Age 65 to 74 | 711 |
| Number Of Beneficiaries Age 75 to 84 | 675 |
| Number Of Beneficiaries Age Greater 84 | 521 |
| Number Of Female Beneficiaries | 1583 |
| Number Of Male Beneficiaries | 985 |
| Number Of Non Hispanic White Beneficiaries | 1716 |
| Number Of Black or African American Beneficiaries | 785 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1487 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1081 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.7619 |