| National Provider Identifier [NPI]: | 1255334900 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | JONG |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 952 SETON DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CUMBERLAND |
| Zip Code Of The Provider | 215021950 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 239 |
| Number Of Services | 42655 |
| Number Of Medicare Beneficiaries | 6663 |
| Total Submitted Charge Amount | 2026070.82 |
| Total Medicare Allowed Amount | 1030437.17 |
| Total Medicare Payment Amount | 790080.22 |
| Total Medicare Standardized Payment Amount | 785397.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 26882 |
| Number Of Medicare Beneficiaries With Drug Services | 499 |
| Total Drug Submitted ChargeAmount | 13433.48 |
| Total Drug Medicare AllowedAmount | 11696.81 |
| Total Drug Medicare PaymentAmount | 8980.66 |
| Total Drug Medicare Standardized Payment Amount | 8980.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 233 |
| Number Of Medical Services | 15773 |
| Number Of Medicare Beneficiaries With Medical Services | 6661 |
| Total Medical Submitted Charge Amount | 2012637.34 |
| Total Medical Medicare Allowed Amount | 1018740.36 |
| Total Medical Medicare Payment Amount | 781099.56 |
| Total Medical Medicare Standardized Payment Amount | 776416.56 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 978 |
| Number Of Beneficiaries Age 65 to 74 | 2952 |
| Number Of Beneficiaries Age 75 to 84 | 1955 |
| Number Of Beneficiaries Age Greater 84 | 778 |
| Number Of Female Beneficiaries | 4324 |
| Number Of Male Beneficiaries | 2339 |
| Number Of Non Hispanic White Beneficiaries | 6467 |
| Number Of Black or African American Beneficiaries | 138 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5185 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1478 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0685 |