| National Provider Identifier [NPI]: | 1760679351 |
| Last Name Of The Provider | KIM-PARK |
| First Name Of The Provider | SANGAE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 52 MEDICAL PARK DR E |
| Street Address 2 Of The Provider | SUITE 312 |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352353430 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 5092 |
| Number Of Medicare Beneficiaries | 362 |
| Total Submitted Charge Amount | 341161.45 |
| Total Medicare Allowed Amount | 258628.13 |
| Total Medicare Payment Amount | 192578.54 |
| Total Medicare Standardized Payment Amount | 207362.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 873 |
| Number Of Medicare Beneficiaries With Drug Services | 164 |
| Total Drug Submitted ChargeAmount | 9718 |
| Total Drug Medicare AllowedAmount | 6603.61 |
| Total Drug Medicare PaymentAmount | 5912.82 |
| Total Drug Medicare Standardized Payment Amount | 5912.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 4219 |
| Number Of Medicare Beneficiaries With Medical Services | 362 |
| Total Medical Submitted Charge Amount | 331443.45 |
| Total Medical Medicare Allowed Amount | 252024.52 |
| Total Medical Medicare Payment Amount | 186665.72 |
| Total Medical Medicare Standardized Payment Amount | 201449.65 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 238 |
| Number Of Male Beneficiaries | 124 |
| Number Of Non Hispanic White Beneficiaries | 261 |
| Number Of Black or African American Beneficiaries | 89 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 259 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 103 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6334 |