| National Provider Identifier [NPI]: | 1366440604 |
| Last Name Of The Provider | JEONG |
| First Name Of The Provider | HWAN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 407 E VERNON AVE |
| Street Address 2 Of The Provider | STE 104 |
| City Of The Provider | NORMAL |
| Zip Code Of The Provider | 617613813 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 112 |
| Number Of Services | 77780 |
| Number Of Medicare Beneficiaries | 427 |
| Total Submitted Charge Amount | 2850160 |
| Total Medicare Allowed Amount | 1308096.94 |
| Total Medicare Payment Amount | 1024008.95 |
| Total Medicare Standardized Payment Amount | 1019922.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 56 |
| Number Of Drug Services | 68465 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 1878928 |
| Total Drug Medicare AllowedAmount | 1009406.15 |
| Total Drug Medicare PaymentAmount | 790327.45 |
| Total Drug Medicare Standardized Payment Amount | 790327.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 9315 |
| Number Of Medicare Beneficiaries With Medical Services | 427 |
| Total Medical Submitted Charge Amount | 971232 |
| Total Medical Medicare Allowed Amount | 298690.79 |
| Total Medical Medicare Payment Amount | 233681.5 |
| Total Medical Medicare Standardized Payment Amount | 229595.08 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 68 |
| Number Of Beneficiaries Age 65 to 74 | 168 |
| Number Of Beneficiaries Age 75 to 84 | 130 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 244 |
| Number Of Male Beneficiaries | 183 |
| Number Of Non Hispanic White Beneficiaries | 401 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 354 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.5507 |