| National Provider Identifier [NPI]: | 1306849492 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | MYUNG-SUP |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 952 SETON DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CUMBERLAND |
| Zip Code Of The Provider | 215021950 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 308 |
| Number Of Services | 65390 |
| Number Of Medicare Beneficiaries | 7957 |
| Total Submitted Charge Amount | 3718358.44 |
| Total Medicare Allowed Amount | 1840702.02 |
| Total Medicare Payment Amount | 1450947.56 |
| Total Medicare Standardized Payment Amount | 1433335.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 46441 |
| Number Of Medicare Beneficiaries With Drug Services | 1000 |
| Total Drug Submitted ChargeAmount | 32302.38 |
| Total Drug Medicare AllowedAmount | 27086.19 |
| Total Drug Medicare PaymentAmount | 21037.59 |
| Total Drug Medicare Standardized Payment Amount | 21037.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 299 |
| Number Of Medical Services | 18949 |
| Number Of Medicare Beneficiaries With Medical Services | 7956 |
| Total Medical Submitted Charge Amount | 3686056.06 |
| Total Medical Medicare Allowed Amount | 1813615.83 |
| Total Medical Medicare Payment Amount | 1429909.97 |
| Total Medical Medicare Standardized Payment Amount | 1412298.24 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1119 |
| Number Of Beneficiaries Age 65 to 74 | 3575 |
| Number Of Beneficiaries Age 75 to 84 | 2378 |
| Number Of Beneficiaries Age Greater 84 | 885 |
| Number Of Female Beneficiaries | 5298 |
| Number Of Male Beneficiaries | 2659 |
| Number Of Non Hispanic White Beneficiaries | 7706 |
| Number Of Black or African American Beneficiaries | 149 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 6353 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1604 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0483 |