| National Provider Identifier [NPI]: | 1215106455 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | SUNG |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3400 SPRUCE ST. |
| Street Address 2 Of The Provider | 1 SILVERSTEIN |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 19104 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 3320 |
| Number Of Medicare Beneficiaries | 2142 |
| Total Submitted Charge Amount | 232604 |
| Total Medicare Allowed Amount | 74519.01 |
| Total Medicare Payment Amount | 56404.26 |
| Total Medicare Standardized Payment Amount | 53817.77 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 550 |
| Number Of Beneficiaries Age 65 to 74 | 930 |
| Number Of Beneficiaries Age 75 to 84 | 486 |
| Number Of Beneficiaries Age Greater 84 | 176 |
| Number Of Female Beneficiaries | 1278 |
| Number Of Male Beneficiaries | 864 |
| Number Of Non Hispanic White Beneficiaries | 1295 |
| Number Of Black or African American Beneficiaries | 698 |
| Number Of AsianPacific Islander Beneficiaries | 47 |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 54 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1565 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 577 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7559 |