| National Provider Identifier [NPI]: | 1013924570 |
| Last Name Of The Provider | SILVERTON |
| First Name Of The Provider | KIMBALL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8245 HOLLY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRAND BLANC |
| Zip Code Of The Provider | 484392443 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 114 |
| Number Of Services | 10424 |
| Number Of Medicare Beneficiaries | 1645 |
| Total Submitted Charge Amount | 918540 |
| Total Medicare Allowed Amount | 656585.88 |
| Total Medicare Payment Amount | 476784 |
| Total Medicare Standardized Payment Amount | 496422.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 716 |
| Number Of Medicare Beneficiaries With Drug Services | 234 |
| Total Drug Submitted ChargeAmount | 21009 |
| Total Drug Medicare AllowedAmount | 18459.42 |
| Total Drug Medicare PaymentAmount | 14276.27 |
| Total Drug Medicare Standardized Payment Amount | 14276.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 111 |
| Number Of Medical Services | 9708 |
| Number Of Medicare Beneficiaries With Medical Services | 1645 |
| Total Medical Submitted Charge Amount | 897531 |
| Total Medical Medicare Allowed Amount | 638126.46 |
| Total Medical Medicare Payment Amount | 462507.73 |
| Total Medical Medicare Standardized Payment Amount | 482145.82 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 363 |
| Number Of Beneficiaries Age 65 to 74 | 654 |
| Number Of Beneficiaries Age 75 to 84 | 433 |
| Number Of Beneficiaries Age Greater 84 | 195 |
| Number Of Female Beneficiaries | 890 |
| Number Of Male Beneficiaries | 755 |
| Number Of Non Hispanic White Beneficiaries | 1465 |
| Number Of Black or African American Beneficiaries | 139 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1289 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 356 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1805 |