| National Provider Identifier [NPI]: | 1760409262 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | DANIEL |
| 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 | 801 S MILWAUKEE ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LIBERTYVILLE |
| Zip Code Of The Provider | 600483199 |
| 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 | 177 |
| Number Of Services | 5260 |
| Number Of Medicare Beneficiaries | 3228 |
| Total Submitted Charge Amount | 719304 |
| Total Medicare Allowed Amount | 190633.2 |
| Total Medicare Payment Amount | 142710.79 |
| Total Medicare Standardized Payment Amount | 138120.58 |
| 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 | 177 |
| Number Of Medical Services | 5260 |
| Number Of Medicare Beneficiaries With Medical Services | 3228 |
| Total Medical Submitted Charge Amount | 719304 |
| Total Medical Medicare Allowed Amount | 190633.2 |
| Total Medical Medicare Payment Amount | 142710.79 |
| Total Medical Medicare Standardized Payment Amount | 138120.58 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 428 |
| Number Of Beneficiaries Age 65 to 74 | 1086 |
| Number Of Beneficiaries Age 75 to 84 | 1007 |
| Number Of Beneficiaries Age Greater 84 | 707 |
| Number Of Female Beneficiaries | 1896 |
| Number Of Male Beneficiaries | 1332 |
| Number Of Non Hispanic White Beneficiaries | 2714 |
| Number Of Black or African American Beneficiaries | 145 |
| Number Of AsianPacific Islander Beneficiaries | 94 |
| Number Of Hispanic Beneficiaries | 224 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2490 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 738 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.7699 |