| National Provider Identifier [NPI]: | 1639173248 |
| Last Name Of The Provider | HIMOT |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 WHITCHER ST NE |
| Street Address 2 Of The Provider | STE 460 |
| City Of The Provider | MARIETTA |
| Zip Code Of The Provider | 300601171 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 14023 |
| Number Of Medicare Beneficiaries | 1355 |
| Total Submitted Charge Amount | 1501812 |
| Total Medicare Allowed Amount | 629321.59 |
| Total Medicare Payment Amount | 473208.82 |
| Total Medicare Standardized Payment Amount | 477952.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 5753 |
| Number Of Medicare Beneficiaries With Drug Services | 273 |
| Total Drug Submitted ChargeAmount | 225493 |
| Total Drug Medicare AllowedAmount | 66261.24 |
| Total Drug Medicare PaymentAmount | 50951.45 |
| Total Drug Medicare Standardized Payment Amount | 50951.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 8270 |
| Number Of Medicare Beneficiaries With Medical Services | 1354 |
| Total Medical Submitted Charge Amount | 1276319 |
| Total Medical Medicare Allowed Amount | 563060.35 |
| Total Medical Medicare Payment Amount | 422257.37 |
| Total Medical Medicare Standardized Payment Amount | 427001.47 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 258 |
| Number Of Beneficiaries Age 65 to 74 | 473 |
| Number Of Beneficiaries Age 75 to 84 | 446 |
| Number Of Beneficiaries Age Greater 84 | 178 |
| Number Of Female Beneficiaries | 698 |
| Number Of Male Beneficiaries | 657 |
| Number Of Non Hispanic White Beneficiaries | 1000 |
| Number Of Black or African American Beneficiaries | 288 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1113 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 242 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 3.1279 |