| National Provider Identifier [NPI]: | 1013984830 |
| Last Name Of The Provider | HILDITCH |
| First Name Of The Provider | KIMBERLY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | P.T. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14300 W GRANITE VALLEY DR |
| Street Address 2 Of The Provider | 21-E |
| City Of The Provider | SUN CITY WEST |
| Zip Code Of The Provider | 853755783 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Therapist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 13419 |
| Number Of Medicare Beneficiaries | 345 |
| Total Submitted Charge Amount | 511834.83 |
| Total Medicare Allowed Amount | 328451.49 |
| Total Medicare Payment Amount | 251334.84 |
| Total Medicare Standardized Payment Amount | 188962.82 |
| 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 | 11 |
| Number Of Medical Services | 13419 |
| Number Of Medicare Beneficiaries With Medical Services | 345 |
| Total Medical Submitted Charge Amount | 511834.83 |
| Total Medical Medicare Allowed Amount | 328451.49 |
| Total Medical Medicare Payment Amount | 251334.84 |
| Total Medical Medicare Standardized Payment Amount | 188962.82 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 146 |
| Number Of Beneficiaries Age 75 to 84 | 132 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 210 |
| Number Of Male Beneficiaries | 135 |
| Number Of Non Hispanic White Beneficiaries | 319 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0958 |