| National Provider Identifier [NPI]: | 1265428924 |
| Last Name Of The Provider | KIMBALL |
| First Name Of The Provider | GLENN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 680 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HAVERHILL |
| Zip Code Of The Provider | 018302644 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 5153 |
| Number Of Medicare Beneficiaries | 2544 |
| Total Submitted Charge Amount | 1465455 |
| Total Medicare Allowed Amount | 649128.44 |
| Total Medicare Payment Amount | 458454.54 |
| Total Medicare Standardized Payment Amount | 445341.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 277 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 24200 |
| Total Drug Medicare AllowedAmount | 15814.36 |
| Total Drug Medicare PaymentAmount | 12322.87 |
| Total Drug Medicare Standardized Payment Amount | 12322.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 4876 |
| Number Of Medicare Beneficiaries With Medical Services | 2544 |
| Total Medical Submitted Charge Amount | 1441255 |
| Total Medical Medicare Allowed Amount | 633314.08 |
| Total Medical Medicare Payment Amount | 446131.67 |
| Total Medical Medicare Standardized Payment Amount | 433018.67 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 156 |
| Number Of Beneficiaries Age 65 to 74 | 960 |
| Number Of Beneficiaries Age 75 to 84 | 948 |
| Number Of Beneficiaries Age Greater 84 | 480 |
| Number Of Female Beneficiaries | 1554 |
| Number Of Male Beneficiaries | 990 |
| Number Of Non Hispanic White Beneficiaries | 2449 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2283 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 261 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0758 |