| National Provider Identifier [NPI]: | 1659395341 |
| Last Name Of The Provider | JIMENEZ |
| First Name Of The Provider | KAREN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19140 S 3RD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CITRONELLE |
| Zip Code Of The Provider | 365222306 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 5300 |
| Number Of Medicare Beneficiaries | 371 |
| Total Submitted Charge Amount | 236741 |
| Total Medicare Allowed Amount | 150708.56 |
| Total Medicare Payment Amount | 113148.6 |
| Total Medicare Standardized Payment Amount | 123004.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 22 |
| Number Of Drug Services | 878 |
| Number Of Medicare Beneficiaries With Drug Services | 226 |
| Total Drug Submitted ChargeAmount | 17011 |
| Total Drug Medicare AllowedAmount | 7081.28 |
| Total Drug Medicare PaymentAmount | 6632.86 |
| Total Drug Medicare Standardized Payment Amount | 6632.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 4422 |
| Number Of Medicare Beneficiaries With Medical Services | 370 |
| Total Medical Submitted Charge Amount | 219730 |
| Total Medical Medicare Allowed Amount | 143627.28 |
| Total Medical Medicare Payment Amount | 106515.74 |
| Total Medical Medicare Standardized Payment Amount | 116371.26 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 165 |
| Number Of Beneficiaries Age 75 to 84 | 90 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 203 |
| Number Of Male Beneficiaries | 168 |
| Number Of Non Hispanic White Beneficiaries | 303 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 298 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1511 |