| National Provider Identifier [NPI]: | 1134340276 |
| Last Name Of The Provider | SIMON |
| First Name Of The Provider | REBECCA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1420 HIGHWAY 62-65 N |
| Street Address 2 Of The Provider | |
| City Of The Provider | HARRISON |
| Zip Code Of The Provider | 726011959 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 143 |
| Number Of Services | 6444 |
| Number Of Medicare Beneficiaries | 295 |
| Total Submitted Charge Amount | 345044.19 |
| Total Medicare Allowed Amount | 193421.82 |
| Total Medicare Payment Amount | 146153.36 |
| Total Medicare Standardized Payment Amount | 160131 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 677 |
| Number Of Medicare Beneficiaries With Drug Services | 182 |
| Total Drug Submitted ChargeAmount | 16074 |
| Total Drug Medicare AllowedAmount | 7734.47 |
| Total Drug Medicare PaymentAmount | 7383.59 |
| Total Drug Medicare Standardized Payment Amount | 7383.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 129 |
| Number Of Medical Services | 5767 |
| Number Of Medicare Beneficiaries With Medical Services | 295 |
| Total Medical Submitted Charge Amount | 328970.19 |
| Total Medical Medicare Allowed Amount | 185687.35 |
| Total Medical Medicare Payment Amount | 138769.77 |
| Total Medical Medicare Standardized Payment Amount | 152747.41 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 134 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 182 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 273 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0471 |