| National Provider Identifier [NPI]: | 1861450330 |
| Last Name Of The Provider | SIMON |
| First Name Of The Provider | GERALD |
| 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 | 412 63RD ST |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | DOWNERS GROVE |
| Zip Code Of The Provider | 605162000 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 6628 |
| Number Of Medicare Beneficiaries | 997 |
| Total Submitted Charge Amount | 1060367 |
| Total Medicare Allowed Amount | 517021.38 |
| Total Medicare Payment Amount | 387707.4 |
| Total Medicare Standardized Payment Amount | 368406.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 1239 |
| Number Of Medicare Beneficiaries With Drug Services | 261 |
| Total Drug Submitted ChargeAmount | 29969 |
| Total Drug Medicare AllowedAmount | 18742.81 |
| Total Drug Medicare PaymentAmount | 15536.3 |
| Total Drug Medicare Standardized Payment Amount | 15536.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 5389 |
| Number Of Medicare Beneficiaries With Medical Services | 997 |
| Total Medical Submitted Charge Amount | 1030398 |
| Total Medical Medicare Allowed Amount | 498278.57 |
| Total Medical Medicare Payment Amount | 372171.1 |
| Total Medical Medicare Standardized Payment Amount | 352870.04 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 296 |
| Number Of Beneficiaries Age 75 to 84 | 379 |
| Number Of Beneficiaries Age Greater 84 | 270 |
| Number Of Female Beneficiaries | 546 |
| Number Of Male Beneficiaries | 451 |
| Number Of Non Hispanic White Beneficiaries | 922 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 905 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4664 |