| National Provider Identifier [NPI]: | 1457633919 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | DONG |
| 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 | 4241 LONG BEACH BLVD |
| Street Address 2 Of The Provider | RAD-IMAGE MEDICAL GROUP INC. |
| City Of The Provider | LONG BEACH |
| Zip Code Of The Provider | 908072003 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 1396 |
| Number Of Medicare Beneficiaries | 1080 |
| Total Submitted Charge Amount | 283552 |
| Total Medicare Allowed Amount | 73289.18 |
| Total Medicare Payment Amount | 56832.81 |
| Total Medicare Standardized Payment Amount | 55483.02 |
| 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 | 117 |
| Number Of Medical Services | 1396 |
| Number Of Medicare Beneficiaries With Medical Services | 1080 |
| Total Medical Submitted Charge Amount | 283552 |
| Total Medical Medicare Allowed Amount | 73289.18 |
| Total Medical Medicare Payment Amount | 56832.81 |
| Total Medical Medicare Standardized Payment Amount | 55483.02 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 176 |
| Number Of Beneficiaries Age 65 to 74 | 329 |
| Number Of Beneficiaries Age 75 to 84 | 328 |
| Number Of Beneficiaries Age Greater 84 | 247 |
| Number Of Female Beneficiaries | 628 |
| Number Of Male Beneficiaries | 452 |
| Number Of Non Hispanic White Beneficiaries | 609 |
| Number Of Black or African American Beneficiaries | 110 |
| Number Of AsianPacific Islander Beneficiaries | 106 |
| Number Of Hispanic Beneficiaries | 217 |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 656 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 424 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.2004 |