| National Provider Identifier [NPI]: | 1992749659 |
| Last Name Of The Provider | KINGMAN |
| First Name Of The Provider | AMY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 682 HEMLOCK ST |
| Street Address 2 Of The Provider | SUITE 490 |
| City Of The Provider | MACON |
| Zip Code Of The Provider | 312018307 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 9628 |
| Number Of Medicare Beneficiaries | 2435 |
| Total Submitted Charge Amount | 2460674.46 |
| Total Medicare Allowed Amount | 811811.59 |
| Total Medicare Payment Amount | 617651.89 |
| Total Medicare Standardized Payment Amount | 655418.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 945 |
| Number Of Medicare Beneficiaries With Drug Services | 189 |
| Total Drug Submitted ChargeAmount | 128520 |
| Total Drug Medicare AllowedAmount | 40520.41 |
| Total Drug Medicare PaymentAmount | 31525.7 |
| Total Drug Medicare Standardized Payment Amount | 31525.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 8683 |
| Number Of Medicare Beneficiaries With Medical Services | 2435 |
| Total Medical Submitted Charge Amount | 2332154.46 |
| Total Medical Medicare Allowed Amount | 771291.18 |
| Total Medical Medicare Payment Amount | 586126.19 |
| Total Medical Medicare Standardized Payment Amount | 623893.17 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 355 |
| Number Of Beneficiaries Age 65 to 74 | 1006 |
| Number Of Beneficiaries Age 75 to 84 | 799 |
| Number Of Beneficiaries Age Greater 84 | 275 |
| Number Of Female Beneficiaries | 1373 |
| Number Of Male Beneficiaries | 1062 |
| Number Of Non Hispanic White Beneficiaries | 1967 |
| Number Of Black or African American Beneficiaries | 429 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2038 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 397 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5333 |