| National Provider Identifier [NPI]: | 1013969039 |
| Last Name Of The Provider | JIMINEZ |
| First Name Of The Provider | VICTOR |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4704 WHITESBURG DR S |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | HUNTSVILLE |
| Zip Code Of The Provider | 358021679 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 6871 |
| Number Of Medicare Beneficiaries | 1089 |
| Total Submitted Charge Amount | 1056617.75 |
| Total Medicare Allowed Amount | 491983.59 |
| Total Medicare Payment Amount | 364361.98 |
| Total Medicare Standardized Payment Amount | 392907.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 1132 |
| Number Of Medicare Beneficiaries With Drug Services | 139 |
| Total Drug Submitted ChargeAmount | 280792.04 |
| Total Drug Medicare AllowedAmount | 96922.6 |
| Total Drug Medicare PaymentAmount | 74445.73 |
| Total Drug Medicare Standardized Payment Amount | 74445.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 5739 |
| Number Of Medicare Beneficiaries With Medical Services | 1089 |
| Total Medical Submitted Charge Amount | 775825.71 |
| Total Medical Medicare Allowed Amount | 395060.99 |
| Total Medical Medicare Payment Amount | 289916.25 |
| Total Medical Medicare Standardized Payment Amount | 318461.41 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 505 |
| Number Of Beneficiaries Age 75 to 84 | 399 |
| Number Of Beneficiaries Age Greater 84 | 110 |
| Number Of Female Beneficiaries | 247 |
| Number Of Male Beneficiaries | 842 |
| Number Of Non Hispanic White Beneficiaries | 959 |
| Number Of Black or African American Beneficiaries | 100 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1018 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 71 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1351 |