| National Provider Identifier [NPI]: | 1144218017 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | JINSUH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 HAWKINS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | IOWA CITY |
| Zip Code Of The Provider | 522421009 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 2182 |
| Number Of Medicare Beneficiaries | 1367 |
| Total Submitted Charge Amount | 536756.6 |
| Total Medicare Allowed Amount | 99422.49 |
| Total Medicare Payment Amount | 73144.83 |
| Total Medicare Standardized Payment Amount | 79642.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 2182 |
| Number Of Medicare Beneficiaries With Medical Services | 1367 |
| Total Medical Submitted Charge Amount | 536756.6 |
| Total Medical Medicare Allowed Amount | 99422.49 |
| Total Medical Medicare Payment Amount | 73144.83 |
| Total Medical Medicare Standardized Payment Amount | 79642.52 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 313 |
| Number Of Beneficiaries Age 65 to 74 | 487 |
| Number Of Beneficiaries Age 75 to 84 | 384 |
| Number Of Beneficiaries Age Greater 84 | 183 |
| Number Of Female Beneficiaries | 721 |
| Number Of Male Beneficiaries | 646 |
| Number Of Non Hispanic White Beneficiaries | 1279 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1005 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 362 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 1.6762 |