| National Provider Identifier [NPI]: | 1366411514 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | LANCE |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2237 SW 19TH AVE RD. |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | OCALA |
| Zip Code Of The Provider | 344717551 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 16007 |
| Number Of Medicare Beneficiaries | 944 |
| Total Submitted Charge Amount | 2940876 |
| Total Medicare Allowed Amount | 1151622.79 |
| Total Medicare Payment Amount | 867616 |
| Total Medicare Standardized Payment Amount | 878833.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 10350 |
| Number Of Medicare Beneficiaries With Drug Services | 275 |
| Total Drug Submitted ChargeAmount | 145595 |
| Total Drug Medicare AllowedAmount | 41113.61 |
| Total Drug Medicare PaymentAmount | 32174.26 |
| Total Drug Medicare Standardized Payment Amount | 32174.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 5657 |
| Number Of Medicare Beneficiaries With Medical Services | 944 |
| Total Medical Submitted Charge Amount | 2795281 |
| Total Medical Medicare Allowed Amount | 1110509.18 |
| Total Medical Medicare Payment Amount | 835441.74 |
| Total Medical Medicare Standardized Payment Amount | 846659.46 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 354 |
| Number Of Beneficiaries Age 65 to 74 | 326 |
| Number Of Beneficiaries Age 75 to 84 | 195 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 549 |
| Number Of Male Beneficiaries | 395 |
| Number Of Non Hispanic White Beneficiaries | 786 |
| Number Of Black or African American Beneficiaries | 82 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 57 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 548 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 396 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 44 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.4513 |