| National Provider Identifier [NPI]: | 1588675961 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | SUNG |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 EAST MEDICAL CENTER DR |
| Street Address 2 Of The Provider | 2ND FLOOR TAUBMAN CTR RECP A |
| City Of The Provider | ANN ARBOR |
| Zip Code Of The Provider | 481095326 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 108 |
| Number Of Services | 3331 |
| Number Of Medicare Beneficiaries | 2132 |
| Total Submitted Charge Amount | 257567 |
| Total Medicare Allowed Amount | 61769.12 |
| Total Medicare Payment Amount | 43649.91 |
| Total Medicare Standardized Payment Amount | 42334.43 |
| 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 | 108 |
| Number Of Medical Services | 3331 |
| Number Of Medicare Beneficiaries With Medical Services | 2132 |
| Total Medical Submitted Charge Amount | 257567 |
| Total Medical Medicare Allowed Amount | 61769.12 |
| Total Medical Medicare Payment Amount | 43649.91 |
| Total Medical Medicare Standardized Payment Amount | 42334.43 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 580 |
| Number Of Beneficiaries Age 65 to 74 | 892 |
| Number Of Beneficiaries Age 75 to 84 | 459 |
| Number Of Beneficiaries Age Greater 84 | 201 |
| Number Of Female Beneficiaries | 1228 |
| Number Of Male Beneficiaries | 904 |
| Number Of Non Hispanic White Beneficiaries | 1745 |
| Number Of Black or African American Beneficiaries | 239 |
| Number Of AsianPacific Islander Beneficiaries | 54 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1630 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 502 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6245 |