| National Provider Identifier [NPI]: | 1467503920 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | JIN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | AKDHC |
| Street Address 2 Of The Provider | 1003 DIVISION ST, STE 5 |
| City Of The Provider | PRESCOTT |
| Zip Code Of The Provider | 863010000 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 30049 |
| Number Of Medicare Beneficiaries | 1027 |
| Total Submitted Charge Amount | 933141 |
| Total Medicare Allowed Amount | 466764.6 |
| Total Medicare Payment Amount | 350088.6 |
| Total Medicare Standardized Payment Amount | 353584.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 26550 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 95140 |
| Total Drug Medicare AllowedAmount | 45844.77 |
| Total Drug Medicare PaymentAmount | 35757.49 |
| Total Drug Medicare Standardized Payment Amount | 35757.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 3499 |
| Number Of Medicare Beneficiaries With Medical Services | 1027 |
| Total Medical Submitted Charge Amount | 838001 |
| Total Medical Medicare Allowed Amount | 420919.83 |
| Total Medical Medicare Payment Amount | 314331.11 |
| Total Medical Medicare Standardized Payment Amount | 317826.97 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 92 |
| Number Of Beneficiaries Age 65 to 74 | 368 |
| Number Of Beneficiaries Age 75 to 84 | 414 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 503 |
| Number Of Male Beneficiaries | 524 |
| Number Of Non Hispanic White Beneficiaries | 947 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 898 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 129 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.1199 |