| National Provider Identifier [NPI]: | 1770559510 |
| Last Name Of The Provider | DAVIDSON |
| First Name Of The Provider | KIMBERLY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1015 CROSSPOINTE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | NAPLES |
| Zip Code Of The Provider | 341100930 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 8615 |
| Number Of Medicare Beneficiaries | 1691 |
| Total Submitted Charge Amount | 667775.1 |
| Total Medicare Allowed Amount | 609427.11 |
| Total Medicare Payment Amount | 443101.93 |
| Total Medicare Standardized Payment Amount | 414369.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 9185.05 |
| Total Drug Medicare AllowedAmount | 9171.31 |
| Total Drug Medicare PaymentAmount | 7183.05 |
| Total Drug Medicare Standardized Payment Amount | 7183.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 8573 |
| Number Of Medicare Beneficiaries With Medical Services | 1691 |
| Total Medical Submitted Charge Amount | 658590.05 |
| Total Medical Medicare Allowed Amount | 600255.8 |
| Total Medical Medicare Payment Amount | 435918.88 |
| Total Medical Medicare Standardized Payment Amount | 407186.28 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 1012 |
| Number Of Beneficiaries Age 75 to 84 | 531 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 937 |
| Number Of Male Beneficiaries | 754 |
| Number Of Non Hispanic White Beneficiaries | 1622 |
| 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 | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1678 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.7848 |