| National Provider Identifier [NPI]: | 1669484903 |
| Last Name Of The Provider | KIMMERLY |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2001 PEACHTREE RD NE |
| Street Address 2 Of The Provider | STE 705 |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303091476 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 655 |
| Number Of Medicare Beneficiaries | 203 |
| Total Submitted Charge Amount | 339594.46 |
| Total Medicare Allowed Amount | 77765.16 |
| Total Medicare Payment Amount | 58947.79 |
| Total Medicare Standardized Payment Amount | 59965.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 59 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 1740 |
| Total Drug Medicare AllowedAmount | 526.81 |
| Total Drug Medicare PaymentAmount | 407.46 |
| Total Drug Medicare Standardized Payment Amount | 407.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 596 |
| Number Of Medicare Beneficiaries With Medical Services | 203 |
| Total Medical Submitted Charge Amount | 337854.46 |
| Total Medical Medicare Allowed Amount | 77238.35 |
| Total Medical Medicare Payment Amount | 58540.33 |
| Total Medical Medicare Standardized Payment Amount | 59558.09 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 96 |
| Number Of Beneficiaries Age 75 to 84 | 52 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 118 |
| Number Of Male Beneficiaries | 85 |
| Number Of Non Hispanic White Beneficiaries | 164 |
| 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 | 189 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.076 |