| National Provider Identifier [NPI]: | 1033148291 |
| Last Name Of The Provider | KWAK |
| First Name Of The Provider | SANDY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1221 N HIGHLAND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | AURORA |
| Zip Code Of The Provider | 605061404 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 153 |
| Number Of Services | 6162 |
| Number Of Medicare Beneficiaries | 1980 |
| Total Submitted Charge Amount | 672512.81 |
| Total Medicare Allowed Amount | 149009.75 |
| Total Medicare Payment Amount | 115240.76 |
| Total Medicare Standardized Payment Amount | 112615.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3027 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 4007 |
| Total Drug Medicare AllowedAmount | 906.7 |
| Total Drug Medicare PaymentAmount | 603.07 |
| Total Drug Medicare Standardized Payment Amount | 603.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 151 |
| Number Of Medical Services | 3135 |
| Number Of Medicare Beneficiaries With Medical Services | 1980 |
| Total Medical Submitted Charge Amount | 668505.81 |
| Total Medical Medicare Allowed Amount | 148103.05 |
| Total Medical Medicare Payment Amount | 114637.69 |
| Total Medical Medicare Standardized Payment Amount | 112012.73 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 324 |
| Number Of Beneficiaries Age 65 to 74 | 767 |
| Number Of Beneficiaries Age 75 to 84 | 567 |
| Number Of Beneficiaries Age Greater 84 | 322 |
| Number Of Female Beneficiaries | 1250 |
| Number Of Male Beneficiaries | 730 |
| Number Of Non Hispanic White Beneficiaries | 1715 |
| Number Of Black or African American Beneficiaries | 107 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 125 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1483 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 497 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6387 |