| National Provider Identifier [NPI]: | 1114976461 |
| Last Name Of The Provider | KIMBALL |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1250 JESSE JEWELL PKWY SE |
| Street Address 2 Of The Provider | SUITE 500 |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 305013871 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 205 |
| Number Of Services | 8444 |
| Number Of Medicare Beneficiaries | 5233 |
| Total Submitted Charge Amount | 1167576 |
| Total Medicare Allowed Amount | 257150.75 |
| Total Medicare Payment Amount | 199789.73 |
| Total Medicare Standardized Payment Amount | 208001.9 |
| 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 | 205 |
| Number Of Medical Services | 8444 |
| Number Of Medicare Beneficiaries With Medical Services | 5233 |
| Total Medical Submitted Charge Amount | 1167576 |
| Total Medical Medicare Allowed Amount | 257150.75 |
| Total Medical Medicare Payment Amount | 199789.73 |
| Total Medical Medicare Standardized Payment Amount | 208001.9 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 718 |
| Number Of Beneficiaries Age 65 to 74 | 2323 |
| Number Of Beneficiaries Age 75 to 84 | 1578 |
| Number Of Beneficiaries Age Greater 84 | 614 |
| Number Of Female Beneficiaries | 3402 |
| Number Of Male Beneficiaries | 1831 |
| Number Of Non Hispanic White Beneficiaries | 4831 |
| Number Of Black or African American Beneficiaries | 204 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 121 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4204 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1029 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3972 |