| National Provider Identifier [NPI]: | 1285696260 |
| Last Name Of The Provider | KIMBLE |
| First Name Of The Provider | CHRISTINE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 CADMAN PLZ W |
| Street Address 2 Of The Provider | 17TH & 18TH FLOORS |
| City Of The Provider | BROOKLYN |
| Zip Code Of The Provider | 112012701 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 954 |
| Number Of Medicare Beneficiaries | 125 |
| Total Submitted Charge Amount | 117287 |
| Total Medicare Allowed Amount | 62770.41 |
| Total Medicare Payment Amount | 45625.51 |
| Total Medicare Standardized Payment Amount | 40275.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 71 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 2849 |
| Total Drug Medicare AllowedAmount | 1946.16 |
| Total Drug Medicare PaymentAmount | 1904.6 |
| Total Drug Medicare Standardized Payment Amount | 1904.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 883 |
| Number Of Medicare Beneficiaries With Medical Services | 125 |
| Total Medical Submitted Charge Amount | 114438 |
| Total Medical Medicare Allowed Amount | 60824.25 |
| Total Medical Medicare Payment Amount | 43720.91 |
| Total Medical Medicare Standardized Payment Amount | 38370.77 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 60 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 99 |
| Number Of Male Beneficiaries | 26 |
| Number Of Non Hispanic White Beneficiaries | 42 |
| Number Of Black or African American Beneficiaries | 66 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 89 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.052 |