| National Provider Identifier [NPI]: | 1508935701 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 E FIRST STREET |
| Street Address 2 Of The Provider | ST MARGARETS HOSPITAL |
| City Of The Provider | SPRING VALLEY |
| Zip Code Of The Provider | 613621512 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 202 |
| Number Of Services | 5590 |
| Number Of Medicare Beneficiaries | 3004 |
| Total Submitted Charge Amount | 497565.93 |
| Total Medicare Allowed Amount | 173687.27 |
| Total Medicare Payment Amount | 131446.49 |
| Total Medicare Standardized Payment Amount | 134404.79 |
| 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 | 202 |
| Number Of Medical Services | 5590 |
| Number Of Medicare Beneficiaries With Medical Services | 3004 |
| Total Medical Submitted Charge Amount | 497565.93 |
| Total Medical Medicare Allowed Amount | 173687.27 |
| Total Medical Medicare Payment Amount | 131446.49 |
| Total Medical Medicare Standardized Payment Amount | 134404.79 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 385 |
| Number Of Beneficiaries Age 65 to 74 | 1104 |
| Number Of Beneficiaries Age 75 to 84 | 922 |
| Number Of Beneficiaries Age Greater 84 | 593 |
| Number Of Female Beneficiaries | 1857 |
| Number Of Male Beneficiaries | 1147 |
| Number Of Non Hispanic White Beneficiaries | 2842 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 121 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2425 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 579 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2996 |