National Provider Identifier [NPI]: |
1881656502 |
Last Name Of The Provider |
GIMBEL |
First Name Of The Provider |
KENNETH |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6507 PROFESSIONAL PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
RIVERDALE |
Zip Code Of The Provider |
302744941 |
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 |
29 |
Number Of Services |
1747 |
Number Of Medicare Beneficiaries |
589 |
Total Submitted Charge Amount |
328914 |
Total Medicare Allowed Amount |
102986.08 |
Total Medicare Payment Amount |
71393.8 |
Total Medicare Standardized Payment Amount |
71617.87 |
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 |
29 |
Number Of Medical Services |
1747 |
Number Of Medicare Beneficiaries With Medical Services |
589 |
Total Medical Submitted Charge Amount |
328914 |
Total Medical Medicare Allowed Amount |
102986.08 |
Total Medical Medicare Payment Amount |
71393.8 |
Total Medical Medicare Standardized Payment Amount |
71617.87 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
226 |
Number Of Beneficiaries Age 75 to 84 |
200 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
294 |
Number Of Male Beneficiaries |
295 |
Number Of Non Hispanic White Beneficiaries |
382 |
Number Of Black or African American Beneficiaries |
175 |
Number Of AsianPacific Islander Beneficiaries |
14 |
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 |
491 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
98 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4339 |