| National Provider Identifier [NPI]: | 1639132681 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8644 SUDLEY RD STE 308 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MANASSAS |
| Zip Code Of The Provider | 201104425 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 4106 |
| Number Of Medicare Beneficiaries | 423 |
| Total Submitted Charge Amount | 501879.1 |
| Total Medicare Allowed Amount | 204545.92 |
| Total Medicare Payment Amount | 153599.93 |
| Total Medicare Standardized Payment Amount | 159467.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2185 |
| Number Of Medicare Beneficiaries With Drug Services | 126 |
| Total Drug Submitted ChargeAmount | 49964.6 |
| Total Drug Medicare AllowedAmount | 21059.91 |
| Total Drug Medicare PaymentAmount | 16488.41 |
| Total Drug Medicare Standardized Payment Amount | 16488.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 1921 |
| Number Of Medicare Beneficiaries With Medical Services | 423 |
| Total Medical Submitted Charge Amount | 451914.5 |
| Total Medical Medicare Allowed Amount | 183486.01 |
| Total Medical Medicare Payment Amount | 137111.52 |
| Total Medical Medicare Standardized Payment Amount | 142979.52 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 239 |
| Number Of Beneficiaries Age 75 to 84 | 115 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 279 |
| Number Of Male Beneficiaries | 144 |
| Number Of Non Hispanic White Beneficiaries | 240 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | 140 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 325 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 98 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9843 |