| National Provider Identifier [NPI]: | 1770532012 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | JONG |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6716 NW 11TH PL |
| Street Address 2 Of The Provider | |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 326054215 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 195 |
| Number Of Services | 11519 |
| Number Of Medicare Beneficiaries | 5167 |
| Total Submitted Charge Amount | 1214500 |
| Total Medicare Allowed Amount | 375500.62 |
| Total Medicare Payment Amount | 286415.66 |
| Total Medicare Standardized Payment Amount | 292358.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 3484 |
| Number Of Medicare Beneficiaries With Drug Services | 95 |
| Total Drug Submitted ChargeAmount | 19948 |
| Total Drug Medicare AllowedAmount | 1285.38 |
| Total Drug Medicare PaymentAmount | 987.81 |
| Total Drug Medicare Standardized Payment Amount | 987.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 189 |
| Number Of Medical Services | 8035 |
| Number Of Medicare Beneficiaries With Medical Services | 5165 |
| Total Medical Submitted Charge Amount | 1194552 |
| Total Medical Medicare Allowed Amount | 374215.24 |
| Total Medical Medicare Payment Amount | 285427.85 |
| Total Medical Medicare Standardized Payment Amount | 291371.11 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 850 |
| Number Of Beneficiaries Age 65 to 74 | 1788 |
| Number Of Beneficiaries Age 75 to 84 | 1629 |
| Number Of Beneficiaries Age Greater 84 | 900 |
| Number Of Female Beneficiaries | 3156 |
| Number Of Male Beneficiaries | 2011 |
| Number Of Non Hispanic White Beneficiaries | 4362 |
| Number Of Black or African American Beneficiaries | 633 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 107 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3639 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1528 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.738 |