| National Provider Identifier [NPI]: | 1134120595 |
| Last Name Of The Provider | KIMMEL |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 360 SUNSET AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ASHEBORO |
| Zip Code Of The Provider | 272035612 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 5016 |
| Number Of Medicare Beneficiaries | 704 |
| Total Submitted Charge Amount | 455461 |
| Total Medicare Allowed Amount | 294363.06 |
| Total Medicare Payment Amount | 213718.62 |
| Total Medicare Standardized Payment Amount | 223641.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 308 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 1078 |
| Total Drug Medicare AllowedAmount | 550.05 |
| Total Drug Medicare PaymentAmount | 340.47 |
| Total Drug Medicare Standardized Payment Amount | 340.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 4708 |
| Number Of Medicare Beneficiaries With Medical Services | 704 |
| Total Medical Submitted Charge Amount | 454383 |
| Total Medical Medicare Allowed Amount | 293813.01 |
| Total Medical Medicare Payment Amount | 213378.15 |
| Total Medical Medicare Standardized Payment Amount | 223301.11 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 326 |
| Number Of Beneficiaries Age 75 to 84 | 205 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 317 |
| Number Of Male Beneficiaries | 387 |
| Number Of Non Hispanic White Beneficiaries | 684 |
| Number Of Black or African American Beneficiaries | |
| 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 | 612 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.088 |