| National Provider Identifier [NPI]: | 1619926391 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | JOON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 431 S BATAVIA ST |
| Street Address 2 Of The Provider | STE. 103 |
| City Of The Provider | ORANGE |
| Zip Code Of The Provider | 928683936 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 193 |
| Number Of Services | 12761 |
| Number Of Medicare Beneficiaries | 2093 |
| Total Submitted Charge Amount | 813226.82 |
| Total Medicare Allowed Amount | 275526.53 |
| Total Medicare Payment Amount | 210243.16 |
| Total Medicare Standardized Payment Amount | 183663.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 9505 |
| Number Of Medicare Beneficiaries With Drug Services | 129 |
| Total Drug Submitted ChargeAmount | 14725 |
| Total Drug Medicare AllowedAmount | 3099.03 |
| Total Drug Medicare PaymentAmount | 2419.41 |
| Total Drug Medicare Standardized Payment Amount | 2419.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 186 |
| Number Of Medical Services | 3256 |
| Number Of Medicare Beneficiaries With Medical Services | 2093 |
| Total Medical Submitted Charge Amount | 798501.82 |
| Total Medical Medicare Allowed Amount | 272427.5 |
| Total Medical Medicare Payment Amount | 207823.75 |
| Total Medical Medicare Standardized Payment Amount | 181243.71 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 225 |
| Number Of Beneficiaries Age 65 to 74 | 786 |
| Number Of Beneficiaries Age 75 to 84 | 707 |
| Number Of Beneficiaries Age Greater 84 | 375 |
| Number Of Female Beneficiaries | 1190 |
| Number Of Male Beneficiaries | 903 |
| Number Of Non Hispanic White Beneficiaries | 1511 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 151 |
| Number Of Hispanic Beneficiaries | 339 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 53 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1640 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 453 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8322 |