| National Provider Identifier [NPI]: | 1083654081 |
| Last Name Of The Provider | SIMON |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5401 S CONGRESS AVE |
| Street Address 2 Of The Provider | #102 |
| City Of The Provider | ATLANTIS |
| Zip Code Of The Provider | 334626635 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 4318 |
| Number Of Medicare Beneficiaries | 1475 |
| Total Submitted Charge Amount | 858673 |
| Total Medicare Allowed Amount | 453752.53 |
| Total Medicare Payment Amount | 345547.21 |
| Total Medicare Standardized Payment Amount | 335047.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 400 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 35200 |
| Total Drug Medicare AllowedAmount | 21150.44 |
| Total Drug Medicare PaymentAmount | 16581.74 |
| Total Drug Medicare Standardized Payment Amount | 16581.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 3918 |
| Number Of Medicare Beneficiaries With Medical Services | 1475 |
| Total Medical Submitted Charge Amount | 823473 |
| Total Medical Medicare Allowed Amount | 432602.09 |
| Total Medical Medicare Payment Amount | 328965.47 |
| Total Medical Medicare Standardized Payment Amount | 318465.7 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 101 |
| Number Of Beneficiaries Age 65 to 74 | 417 |
| Number Of Beneficiaries Age 75 to 84 | 536 |
| Number Of Beneficiaries Age Greater 84 | 421 |
| Number Of Female Beneficiaries | 722 |
| Number Of Male Beneficiaries | 753 |
| Number Of Non Hispanic White Beneficiaries | 1289 |
| Number Of Black or African American Beneficiaries | 68 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 93 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1266 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 209 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 74 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8653 |