| National Provider Identifier [NPI]: | 1437258183 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | STEVENS |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 36 WEST YOKUTS AVE |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | STOCKTON |
| Zip Code Of The Provider | 952075713 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 3516 |
| Number Of Medicare Beneficiaries | 1386 |
| Total Submitted Charge Amount | 1251312.25 |
| Total Medicare Allowed Amount | 560587.32 |
| Total Medicare Payment Amount | 410842.43 |
| Total Medicare Standardized Payment Amount | 392423.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 101 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 21950 |
| Total Drug Medicare AllowedAmount | 10331.92 |
| Total Drug Medicare PaymentAmount | 8100.22 |
| Total Drug Medicare Standardized Payment Amount | 8100.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 3415 |
| Number Of Medicare Beneficiaries With Medical Services | 1386 |
| Total Medical Submitted Charge Amount | 1229362.25 |
| Total Medical Medicare Allowed Amount | 550255.4 |
| Total Medical Medicare Payment Amount | 402742.21 |
| Total Medical Medicare Standardized Payment Amount | 384322.94 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 601 |
| Number Of Beneficiaries Age 75 to 84 | 471 |
| Number Of Beneficiaries Age Greater 84 | 212 |
| Number Of Female Beneficiaries | 876 |
| Number Of Male Beneficiaries | 510 |
| Number Of Non Hispanic White Beneficiaries | 948 |
| Number Of Black or African American Beneficiaries | 49 |
| Number Of AsianPacific Islander Beneficiaries | 123 |
| Number Of Hispanic Beneficiaries | 242 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1042 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 344 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2116 |