| National Provider Identifier [NPI]: | 1609824416 |
| Last Name Of The Provider | SIMON |
| First Name Of The Provider | TIMOTHY |
| 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 | 5555 PEACHTREE DUNWOODY RD NE |
| Street Address 2 Of The Provider | SUITE 206 |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303421703 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Colorectal Surgery (formerly proctology) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 661 |
| Number Of Medicare Beneficiaries | 263 |
| Total Submitted Charge Amount | 424091 |
| Total Medicare Allowed Amount | 118480.16 |
| Total Medicare Payment Amount | 89374.03 |
| Total Medicare Standardized Payment Amount | 96712.7 |
| 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 | 86 |
| Number Of Medical Services | 661 |
| Number Of Medicare Beneficiaries With Medical Services | 263 |
| Total Medical Submitted Charge Amount | 424091 |
| Total Medical Medicare Allowed Amount | 118480.16 |
| Total Medical Medicare Payment Amount | 89374.03 |
| Total Medical Medicare Standardized Payment Amount | 96712.7 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 42 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 140 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 193 |
| 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 | 174 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 89 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.844 |