| National Provider Identifier [NPI]: | 1396955076 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | NANCY |
| 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 | 7425 E SHEA BLVD |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | SCOTTSDALE |
| Zip Code Of The Provider | 852606411 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 6849 |
| Number Of Medicare Beneficiaries | 1220 |
| Total Submitted Charge Amount | 1623562 |
| Total Medicare Allowed Amount | 607997.56 |
| Total Medicare Payment Amount | 453408.53 |
| Total Medicare Standardized Payment Amount | 420169.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 183 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 24810 |
| Total Drug Medicare AllowedAmount | 13779.86 |
| Total Drug Medicare PaymentAmount | 10795.7 |
| Total Drug Medicare Standardized Payment Amount | 10795.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 6666 |
| Number Of Medicare Beneficiaries With Medical Services | 1220 |
| Total Medical Submitted Charge Amount | 1598752 |
| Total Medical Medicare Allowed Amount | 594217.7 |
| Total Medical Medicare Payment Amount | 442612.83 |
| Total Medical Medicare Standardized Payment Amount | 409373.31 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 734 |
| Number Of Beneficiaries Age 75 to 84 | 323 |
| Number Of Beneficiaries Age Greater 84 | 139 |
| Number Of Female Beneficiaries | 698 |
| Number Of Male Beneficiaries | 522 |
| Number Of Non Hispanic White Beneficiaries | 1168 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1199 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 13 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8252 |