| National Provider Identifier [NPI]: | 1447288543 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | IL |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3919 BEVERLY BLVD |
| Street Address 2 Of The Provider | #100 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900043432 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 4286 |
| Number Of Medicare Beneficiaries | 409 |
| Total Submitted Charge Amount | 1040095.01 |
| Total Medicare Allowed Amount | 357104.98 |
| Total Medicare Payment Amount | 278747.9 |
| Total Medicare Standardized Payment Amount | 258376.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 101 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 5100 |
| Total Drug Medicare AllowedAmount | 1704.77 |
| Total Drug Medicare PaymentAmount | 1662.84 |
| Total Drug Medicare Standardized Payment Amount | 1662.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 4185 |
| Number Of Medicare Beneficiaries With Medical Services | 409 |
| Total Medical Submitted Charge Amount | 1034995.01 |
| Total Medical Medicare Allowed Amount | 355400.21 |
| Total Medical Medicare Payment Amount | 277085.06 |
| Total Medical Medicare Standardized Payment Amount | 256713.47 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 143 |
| Number Of Beneficiaries Age 75 to 84 | 141 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 229 |
| Number Of Male Beneficiaries | 180 |
| Number Of Non Hispanic White Beneficiaries | 55 |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | 201 |
| Number Of Hispanic Beneficiaries | 81 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 36 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 373 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 35 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 62 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 69 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 26 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 22 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.333 |