| National Provider Identifier [NPI]: | 1366428146 |
| Last Name Of The Provider | KIMBROUGH-GREEN |
| First Name Of The Provider | CANDANCE |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1519 JOHNSON FERRY RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MARIETTA |
| Zip Code Of The Provider | 300626409 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 3881 |
| Number Of Medicare Beneficiaries | 953 |
| Total Submitted Charge Amount | 252088.3 |
| Total Medicare Allowed Amount | 230224.18 |
| Total Medicare Payment Amount | 160440.6 |
| Total Medicare Standardized Payment Amount | 158221.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 201 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 20238.02 |
| Total Drug Medicare AllowedAmount | 19641.24 |
| Total Drug Medicare PaymentAmount | 15361.64 |
| Total Drug Medicare Standardized Payment Amount | 15361.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 3680 |
| Number Of Medicare Beneficiaries With Medical Services | 953 |
| Total Medical Submitted Charge Amount | 231850.28 |
| Total Medical Medicare Allowed Amount | 210582.94 |
| Total Medical Medicare Payment Amount | 145078.96 |
| Total Medical Medicare Standardized Payment Amount | 142859.81 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 591 |
| Number Of Beneficiaries Age 75 to 84 | 243 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 548 |
| Number Of Male Beneficiaries | 405 |
| Number Of Non Hispanic White Beneficiaries | 892 |
| Number Of Black or African American Beneficiaries | 24 |
| 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 | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 936 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.7856 |