| National Provider Identifier [NPI]: | 1518013689 |
| Last Name Of The Provider | SHIM |
| First Name Of The Provider | ELISABETH |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1301 20TH ST |
| Street Address 2 Of The Provider | SUITE 570 |
| City Of The Provider | SANTA MONICA |
| Zip Code Of The Provider | 90404 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 5218 |
| Number Of Medicare Beneficiaries | 621 |
| Total Submitted Charge Amount | 921509 |
| Total Medicare Allowed Amount | 804860.56 |
| Total Medicare Payment Amount | 622059.06 |
| Total Medicare Standardized Payment Amount | 525278.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 20 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 59 |
| Total Drug Medicare AllowedAmount | 47.87 |
| Total Drug Medicare PaymentAmount | 40.31 |
| Total Drug Medicare Standardized Payment Amount | 40.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 5198 |
| Number Of Medicare Beneficiaries With Medical Services | 621 |
| Total Medical Submitted Charge Amount | 921450 |
| Total Medical Medicare Allowed Amount | 804812.69 |
| Total Medical Medicare Payment Amount | 622018.75 |
| Total Medical Medicare Standardized Payment Amount | 525238.26 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 233 |
| Number Of Beneficiaries Age 75 to 84 | 217 |
| Number Of Beneficiaries Age Greater 84 | 156 |
| Number Of Female Beneficiaries | 336 |
| Number Of Male Beneficiaries | 285 |
| Number Of Non Hispanic White Beneficiaries | 582 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 556 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1 |