| National Provider Identifier [NPI]: | 1205804622 |
| Last Name Of The Provider | ADAMES |
| First Name Of The Provider | SIMON |
| 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 | 3386 GREYSTONE WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | VALDOSTA |
| Zip Code Of The Provider | 316051096 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 2269 |
| Number Of Medicare Beneficiaries | 1014 |
| Total Submitted Charge Amount | 1162776.45 |
| Total Medicare Allowed Amount | 205223.63 |
| Total Medicare Payment Amount | 154093.71 |
| Total Medicare Standardized Payment Amount | 159065.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 63 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 390 |
| Total Drug Medicare AllowedAmount | 127.98 |
| Total Drug Medicare PaymentAmount | 89.73 |
| Total Drug Medicare Standardized Payment Amount | 89.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 2206 |
| Number Of Medicare Beneficiaries With Medical Services | 1014 |
| Total Medical Submitted Charge Amount | 1162386.45 |
| Total Medical Medicare Allowed Amount | 205095.65 |
| Total Medical Medicare Payment Amount | 154003.98 |
| Total Medical Medicare Standardized Payment Amount | 158976.01 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 327 |
| Number Of Beneficiaries Age 65 to 74 | 337 |
| Number Of Beneficiaries Age 75 to 84 | 226 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 606 |
| Number Of Male Beneficiaries | 408 |
| Number Of Non Hispanic White Beneficiaries | 636 |
| Number Of Black or African American Beneficiaries | 330 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 568 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 446 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8845 |