| National Provider Identifier [NPI]: | 1558523217 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | JI |
| 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 | 1500 DUARTE RD |
| Street Address 2 Of The Provider | RADIATION ONCOLOGY |
| City Of The Provider | DUARTE |
| Zip Code Of The Provider | 910103012 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Radiation Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 4401 |
| Number Of Medicare Beneficiaries | 106 |
| Total Submitted Charge Amount | 3859332.88 |
| Total Medicare Allowed Amount | 1073809.76 |
| Total Medicare Payment Amount | 837885.88 |
| Total Medicare Standardized Payment Amount | 738745.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 95 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 2517.8 |
| Total Drug Medicare AllowedAmount | 704.85 |
| Total Drug Medicare PaymentAmount | 552.63 |
| Total Drug Medicare Standardized Payment Amount | 552.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 4306 |
| Number Of Medicare Beneficiaries With Medical Services | 106 |
| Total Medical Submitted Charge Amount | 3856815.08 |
| Total Medical Medicare Allowed Amount | 1073104.91 |
| Total Medical Medicare Payment Amount | 837333.25 |
| Total Medical Medicare Standardized Payment Amount | 738192.81 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 40 |
| Number Of Male Beneficiaries | 66 |
| Number Of Non Hispanic White Beneficiaries | 77 |
| Number Of Black or African American Beneficiaries | 14 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 78 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 59 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.9234 |