| National Provider Identifier [NPI]: | 1376527382 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3901 W 15TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PLANO |
| Zip Code Of The Provider | 750757738 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 207 |
| Number Of Services | 5558 |
| Number Of Medicare Beneficiaries | 3611 |
| Total Submitted Charge Amount | 754429.54 |
| Total Medicare Allowed Amount | 159838.51 |
| Total Medicare Payment Amount | 121531.2 |
| Total Medicare Standardized Payment Amount | 127470.25 |
| 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 | 207 |
| Number Of Medical Services | 5558 |
| Number Of Medicare Beneficiaries With Medical Services | 3611 |
| Total Medical Submitted Charge Amount | 754429.54 |
| Total Medical Medicare Allowed Amount | 159838.51 |
| Total Medical Medicare Payment Amount | 121531.2 |
| Total Medical Medicare Standardized Payment Amount | 127470.25 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 539 |
| Number Of Beneficiaries Age 65 to 74 | 1330 |
| Number Of Beneficiaries Age 75 to 84 | 1085 |
| Number Of Beneficiaries Age Greater 84 | 657 |
| Number Of Female Beneficiaries | 2193 |
| Number Of Male Beneficiaries | 1418 |
| Number Of Non Hispanic White Beneficiaries | 3026 |
| Number Of Black or African American Beneficiaries | 239 |
| Number Of AsianPacific Islander Beneficiaries | 110 |
| Number Of Hispanic Beneficiaries | 186 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2892 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 719 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8578 |