| National Provider Identifier [NPI]: | 1114920477 |
| Last Name Of The Provider | SHIN |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 901 E ST |
| Street Address 2 Of The Provider | STE 285 |
| City Of The Provider | SAN RAFAEL |
| Zip Code Of The Provider | 949012850 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 5643 |
| Number Of Medicare Beneficiaries | 2718 |
| Total Submitted Charge Amount | 1239402.58 |
| Total Medicare Allowed Amount | 777862.64 |
| Total Medicare Payment Amount | 537354.01 |
| Total Medicare Standardized Payment Amount | 467566.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 5643 |
| Number Of Medicare Beneficiaries With Medical Services | 2718 |
| Total Medical Submitted Charge Amount | 1239402.58 |
| Total Medical Medicare Allowed Amount | 777862.64 |
| Total Medical Medicare Payment Amount | 537354.01 |
| Total Medical Medicare Standardized Payment Amount | 467566.56 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 1029 |
| Number Of Beneficiaries Age 75 to 84 | 956 |
| Number Of Beneficiaries Age Greater 84 | 640 |
| Number Of Female Beneficiaries | 1634 |
| Number Of Male Beneficiaries | 1084 |
| Number Of Non Hispanic White Beneficiaries | 2461 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 113 |
| Number Of Hispanic Beneficiaries | 75 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2482 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 236 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.963 |