| National Provider Identifier [NPI]: | 1023124054 |
| Last Name Of The Provider | PAK |
| First Name Of The Provider | JAESOO |
| 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 | 11841 SOUTH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CERRITOS |
| Zip Code Of The Provider | 907036825 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 12603 |
| Number Of Medicare Beneficiaries | 778 |
| Total Submitted Charge Amount | 1218630 |
| Total Medicare Allowed Amount | 472928.52 |
| Total Medicare Payment Amount | 368831.38 |
| Total Medicare Standardized Payment Amount | 347502.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 2908 |
| Number Of Medicare Beneficiaries With Drug Services | 578 |
| Total Drug Submitted ChargeAmount | 78535 |
| Total Drug Medicare AllowedAmount | 11145.93 |
| Total Drug Medicare PaymentAmount | 10479.45 |
| Total Drug Medicare Standardized Payment Amount | 10479.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 9695 |
| Number Of Medicare Beneficiaries With Medical Services | 778 |
| Total Medical Submitted Charge Amount | 1140095 |
| Total Medical Medicare Allowed Amount | 461782.59 |
| Total Medical Medicare Payment Amount | 358351.93 |
| Total Medical Medicare Standardized Payment Amount | 337023.34 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 302 |
| Number Of Beneficiaries Age 75 to 84 | 378 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 496 |
| Number Of Male Beneficiaries | 282 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 732 |
| 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 | 124 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 654 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 75 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 60 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.0782 |