Physician

Tommie Simon, M.D.

According to 2025 Medicare claims, Tommie Simon, M.D. (NPI: 1043653264) practices rheumatology in the Lawton, OK market, with the plurality of this provider's patient population coming from Comanche, OK. This provider's primary affiliated billing organization is TOMMIE SIMON MD, PLLC (NPI: 1689179715; TIN: 82-4374830) and primary practice location at 73505-9618. Simon is affiliated with the Lifecare ACO LLC (ACO ID: A3644) and Caravan Health ACO 43 LLC (ACO ID: A4974), participating under the MSSP model.

Simon's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 708 traditional Medicare patients, billed 213,555 HCPCS/CPT codes, and received $2,618,047 in Medicare payments. The top billing code was 99204 (New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more). Part D data shows 2,367 prescription claims across 482 beneficiaries totaling $2,778,229 in drug costs, led by Humira(Cf) Pen (Adalimumab). Open Payments data shows 7 records totaling $156. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing did not follow a clear longitudinal pattern. Concurrently, Part D prescription costs have risen steadily, from $21,139 to $2,778,229. For DME billing, this provider has fewer than 5 years of reported data, so a reliable trend cannot be assigned.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Part B Carrier Billing Trend. X-axis: year 2015-2024. Y-axis: Medicare payment, unit: USD. Field: Tot_Mdcr_Pymt_Amt. Source: Medicare Physician & Other Practitioners by Provider.0$1.8M$3.7M2018 Medicare payment: $350,567 (USD; Tot_Mdcr_Pymt_Amt)2019 Medicare payment: $2,619,523 (USD; Tot_Mdcr_Pymt_Amt)2020 Medicare payment: $3,680,802 (USD; Tot_Mdcr_Pymt_Amt)2021 Medicare payment: $3,334,536 (USD; Tot_Mdcr_Pymt_Amt)2022 Medicare payment: $2,717,009 (USD; Tot_Mdcr_Pymt_Amt)2023 Medicare payment: $2,494,418 (USD; Tot_Mdcr_Pymt_Amt)2024 Medicare payment: $2,618,047 (USD; Tot_Mdcr_Pymt_Amt)2015201620172018201920202021202220232024
YearPatientsClm LinesPayment
2015N/RN/RN/R
2016N/RN/RN/R
2017N/RN/RN/R
201821913,597$350,567
2019643151,230$2,619,523
2020823207,626$3,680,802
2021837208,304$3,334,536
2022761188,330$2,717,009
2023722188,155$2,494,418
2024708213,555$2,618,047

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Part D Events Trend. X-axis: year 2015-2024. Y-axis: Drug cost, unit: USD. Field: Tot_Drug_Cst. Source: Medicare Part D Prescribers by Provider.0$1.4M$2.8M2015 Drug cost: $21,139 (USD; Tot_Drug_Cst)2016 Drug cost: $63,290 (USD; Tot_Drug_Cst)2017 Drug cost: $207,205 (USD; Tot_Drug_Cst)2018 Drug cost: $302,919 (USD; Tot_Drug_Cst)2019 Drug cost: $898,933 (USD; Tot_Drug_Cst)2020 Drug cost: $2,072,615 (USD; Tot_Drug_Cst)2021 Drug cost: $2,310,558 (USD; Tot_Drug_Cst)2022 Drug cost: $2,342,326 (USD; Tot_Drug_Cst)2023 Drug cost: $2,575,236 (USD; Tot_Drug_Cst)2024 Drug cost: $2,778,229 (USD; Tot_Drug_Cst)2015201620172018201920202021202220232024
YearPatientsClaimsDrug Cost
201567400$21,139
201644376$63,290
201720181$207,205
2018128511$302,919
20193382,055$898,933
20204062,330$2,072,615
20214772,677$2,310,558
20224922,677$2,342,326
20234492,260$2,575,236
20244822,367$2,778,229

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

No connected DME records

No connected DME records

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

CodeDescriptionPatientsClm LinesTotal Payment
99204New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more137137$103
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more5781,073$83
G2211Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's542977$12
96372Injection of drug or substance under skin or into muscle132427$9
36415Insertion of needle into vein for collection of blood sample248300$8

Top 5 Part D drugs in 2024

By total drug costs.

DrugGenericClaimsTotal Day SupplyTotal Drug Cost
Humira(Cf) PenAdalimumab1554,564$1,117,103
Enbrel SureclickEtanercept571,596$436,341
RinvoqUpadacitinib501,500$321,693
Skyrizi PenRisankizumab-Rzaa11756$226,762
Cosentyx Sensoready (2 Pens)Secukinumab16448$132,948

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary in 2024

CategoryDefinitionRecordsTotal Reported AmountTop Related Entity
General PaymentsReported payment or transfer-of-value amount.7$156Janssen Biotech, Inc.
Research PaymentsReported research-related payment or transfer-of-value amount.0$0N/R
Ownership / Investment InterestsReported value of ownership or investment interests.0$0N/R

FAQ

What Medicare data is available for Tommie Simon, M.D.?

Tedicare shows public-source Medicare data for Tommie Simon, M.D. (NPI 1043653264), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Tommie Simon, M.D. have ACO affiliation data?

Tommie Simon, M.D. is shown with ACO affiliation data for Lifecare ACO LLC (MSSP, ACO ID A3644) and Caravan Health ACO 43 LLC (MSSP, ACO ID A4974).

What billing organization is linked to Tommie Simon, M.D.?

Tommie Simon, M.D. is linked to TOMMIE SIMON MD, PLLC (billing NPI 1689179715) in the available physician profile data.

Does Tommie Simon, M.D. have Open Payments data?

Tommie Simon, M.D. has 7 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.