| National Provider Identifier [NPI]: | 1033119417 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | SANG |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9002 N MERIDIAN ST |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462605381 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 10528 |
| Number Of Medicare Beneficiaries | 1012 |
| Total Submitted Charge Amount | 3466571 |
| Total Medicare Allowed Amount | 1155169.71 |
| Total Medicare Payment Amount | 866807.45 |
| Total Medicare Standardized Payment Amount | 901045.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 3811 |
| Number Of Medicare Beneficiaries With Drug Services | 103 |
| Total Drug Submitted ChargeAmount | 1039464 |
| Total Drug Medicare AllowedAmount | 548291.33 |
| Total Drug Medicare PaymentAmount | 424787.34 |
| Total Drug Medicare Standardized Payment Amount | 424787.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 6717 |
| Number Of Medicare Beneficiaries With Medical Services | 1012 |
| Total Medical Submitted Charge Amount | 2427107 |
| Total Medical Medicare Allowed Amount | 606878.38 |
| Total Medical Medicare Payment Amount | 442020.11 |
| Total Medical Medicare Standardized Payment Amount | 476258.22 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 372 |
| Number Of Beneficiaries Age 75 to 84 | 326 |
| Number Of Beneficiaries Age Greater 84 | 248 |
| Number Of Female Beneficiaries | 611 |
| Number Of Male Beneficiaries | 401 |
| Number Of Non Hispanic White Beneficiaries | 947 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 928 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 84 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4077 |