| National Provider Identifier [NPI]: | 1285618389 |
| Last Name Of The Provider | SIMON |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 27700 MEDICAL CENTER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MISSION VIEJO |
| Zip Code Of The Provider | 926916426 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 3039 |
| Number Of Medicare Beneficiaries | 1420 |
| Total Submitted Charge Amount | 246544.51 |
| Total Medicare Allowed Amount | 82760.47 |
| Total Medicare Payment Amount | 69799.34 |
| Total Medicare Standardized Payment Amount | 65368.68 |
| 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 | 59 |
| Number Of Medical Services | 3039 |
| Number Of Medicare Beneficiaries With Medical Services | 1420 |
| Total Medical Submitted Charge Amount | 246544.51 |
| Total Medical Medicare Allowed Amount | 82760.47 |
| Total Medical Medicare Payment Amount | 69799.34 |
| Total Medical Medicare Standardized Payment Amount | 65368.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 792 |
| Number Of Beneficiaries Age 75 to 84 | 441 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 1314 |
| Number Of Male Beneficiaries | 106 |
| Number Of Non Hispanic White Beneficiaries | 1231 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | 66 |
| Number Of Hispanic Beneficiaries | 78 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1293 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.886 |