| National Provider Identifier [NPI]: | 1255643201 |
| Last Name Of The Provider | KIM |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 23625 WR HOLMAN HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MONTEREY |
| Zip Code Of The Provider | 939405902 |
| 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 | 20 |
| Number Of Services | 1666 |
| Number Of Medicare Beneficiaries | 610 |
| Total Submitted Charge Amount | 349464.13 |
| Total Medicare Allowed Amount | 173643.8 |
| Total Medicare Payment Amount | 132630.45 |
| Total Medicare Standardized Payment Amount | 130699.44 |
| 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 | 20 |
| Number Of Medical Services | 1666 |
| Number Of Medicare Beneficiaries With Medical Services | 610 |
| Total Medical Submitted Charge Amount | 349464.13 |
| Total Medical Medicare Allowed Amount | 173643.8 |
| Total Medical Medicare Payment Amount | 132630.45 |
| Total Medical Medicare Standardized Payment Amount | 130699.44 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 76 |
| Number Of Beneficiaries Age 65 to 74 | 164 |
| Number Of Beneficiaries Age 75 to 84 | 208 |
| Number Of Beneficiaries Age Greater 84 | 162 |
| Number Of Female Beneficiaries | 348 |
| Number Of Male Beneficiaries | 262 |
| Number Of Non Hispanic White Beneficiaries | 469 |
| Number Of Black or African American Beneficiaries | 38 |
| Number Of AsianPacific Islander Beneficiaries | 38 |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 447 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 163 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9389 |