| National Provider Identifier [NPI]: | 1982634507 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10117 NE 58TH ST |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | KIRKLAND |
| Zip Code Of The Provider | 980337450 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 5893 |
| Number Of Medicare Beneficiaries | 732 |
| Total Submitted Charge Amount | 630956 |
| Total Medicare Allowed Amount | 384293.05 |
| Total Medicare Payment Amount | 284018.99 |
| Total Medicare Standardized Payment Amount | 265852.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 37 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 2028 |
| Total Drug Medicare AllowedAmount | 1051.73 |
| Total Drug Medicare PaymentAmount | 824.57 |
| Total Drug Medicare Standardized Payment Amount | 824.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 5856 |
| Number Of Medicare Beneficiaries With Medical Services | 732 |
| Total Medical Submitted Charge Amount | 628928 |
| Total Medical Medicare Allowed Amount | 383241.32 |
| Total Medical Medicare Payment Amount | 283194.42 |
| Total Medical Medicare Standardized Payment Amount | 265027.61 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 372 |
| Number Of Beneficiaries Age 75 to 84 | 239 |
| Number Of Beneficiaries Age Greater 84 | 103 |
| Number Of Female Beneficiaries | 438 |
| Number Of Male Beneficiaries | 294 |
| Number Of Non Hispanic White Beneficiaries | 694 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 718 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 12 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8459 |