| National Provider Identifier [NPI]: | 1417925900 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4208 EVERGREEN LN |
| Street Address 2 Of The Provider | SUITE 222 |
| City Of The Provider | ANNANDALE |
| Zip Code Of The Provider | 220033235 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 16014 |
| Number Of Medicare Beneficiaries | 495 |
| Total Submitted Charge Amount | 791030 |
| Total Medicare Allowed Amount | 637478.4 |
| Total Medicare Payment Amount | 468897.89 |
| Total Medicare Standardized Payment Amount | 427950.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 11375 |
| Number Of Medicare Beneficiaries With Drug Services | 334 |
| Total Drug Submitted ChargeAmount | 188065 |
| Total Drug Medicare AllowedAmount | 167132.24 |
| Total Drug Medicare PaymentAmount | 132795.48 |
| Total Drug Medicare Standardized Payment Amount | 132795.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 4639 |
| Number Of Medicare Beneficiaries With Medical Services | 495 |
| Total Medical Submitted Charge Amount | 602965 |
| Total Medical Medicare Allowed Amount | 470346.16 |
| Total Medical Medicare Payment Amount | 336102.41 |
| Total Medical Medicare Standardized Payment Amount | 295155.26 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 184 |
| Number Of Beneficiaries Age 75 to 84 | 224 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 328 |
| Number Of Male Beneficiaries | 167 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 448 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 180 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 315 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 7 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | 39 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9075 |