| National Provider Identifier [NPI]: | 1952526972 |
| Last Name Of The Provider | PARK |
| First Name Of The Provider | JONG |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3215 N NORTHHILLS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FAYETTEVILLE |
| Zip Code Of The Provider | 727034424 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 259 |
| Number Of Services | 5117 |
| Number Of Medicare Beneficiaries | 2750 |
| Total Submitted Charge Amount | 672572 |
| Total Medicare Allowed Amount | 208143.63 |
| Total Medicare Payment Amount | 157186.66 |
| Total Medicare Standardized Payment Amount | 169428.97 |
| 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 | 259 |
| Number Of Medical Services | 5117 |
| Number Of Medicare Beneficiaries With Medical Services | 2750 |
| Total Medical Submitted Charge Amount | 672572 |
| Total Medical Medicare Allowed Amount | 208143.63 |
| Total Medical Medicare Payment Amount | 157186.66 |
| Total Medical Medicare Standardized Payment Amount | 169428.97 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 542 |
| Number Of Beneficiaries Age 65 to 74 | 952 |
| Number Of Beneficiaries Age 75 to 84 | 812 |
| Number Of Beneficiaries Age Greater 84 | 444 |
| Number Of Female Beneficiaries | 1571 |
| Number Of Male Beneficiaries | 1179 |
| Number Of Non Hispanic White Beneficiaries | 2598 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | 53 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2040 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 710 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.71 |