| National Provider Identifier [NPI]: | 1740387646 |
| Last Name Of The Provider | SHIN |
| First Name Of The Provider | DONG |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3030 W OLYMPIC BLVD |
| Street Address 2 Of The Provider | 206 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900066501 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 11682 |
| Number Of Medicare Beneficiaries | 543 |
| Total Submitted Charge Amount | 739177 |
| Total Medicare Allowed Amount | 642906.23 |
| Total Medicare Payment Amount | 484238.68 |
| Total Medicare Standardized Payment Amount | 442222.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 1329 |
| Number Of Medicare Beneficiaries With Drug Services | 330 |
| Total Drug Submitted ChargeAmount | 51419 |
| Total Drug Medicare AllowedAmount | 40986.84 |
| Total Drug Medicare PaymentAmount | 32819.65 |
| Total Drug Medicare Standardized Payment Amount | 32819.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 10353 |
| Number Of Medicare Beneficiaries With Medical Services | 543 |
| Total Medical Submitted Charge Amount | 687758 |
| Total Medical Medicare Allowed Amount | 601919.39 |
| Total Medical Medicare Payment Amount | 451419.03 |
| Total Medical Medicare Standardized Payment Amount | 409402.72 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 208 |
| Number Of Beneficiaries Age 75 to 84 | 226 |
| Number Of Beneficiaries Age Greater 84 | 95 |
| Number Of Female Beneficiaries | 363 |
| Number Of Male Beneficiaries | 180 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 519 |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 24 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 519 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 3 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 6 |
| Percent Of With Diabetes | 75 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.321 |