| National Provider Identifier [NPI]: | 1114904398 |
| Last Name Of The Provider | KIMBALL |
| First Name Of The Provider | JAY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6450 N CHATHAM AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | KANSAS CITY |
| Zip Code Of The Provider | 64151 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 1095 |
| Number Of Medicare Beneficiaries | 367 |
| Total Submitted Charge Amount | 115068 |
| Total Medicare Allowed Amount | 73403.62 |
| Total Medicare Payment Amount | 49643.13 |
| Total Medicare Standardized Payment Amount | 51716.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 130 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 5465 |
| Total Drug Medicare AllowedAmount | 3023.39 |
| Total Drug Medicare PaymentAmount | 2869.24 |
| Total Drug Medicare Standardized Payment Amount | 2869.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 965 |
| Number Of Medicare Beneficiaries With Medical Services | 367 |
| Total Medical Submitted Charge Amount | 109603 |
| Total Medical Medicare Allowed Amount | 70380.23 |
| Total Medical Medicare Payment Amount | 46773.89 |
| Total Medical Medicare Standardized Payment Amount | 48847.18 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 255 |
| Number Of Beneficiaries Age 75 to 84 | 80 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 164 |
| Number Of Male Beneficiaries | 203 |
| Number Of Non Hispanic White Beneficiaries | 348 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 7 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7255 |