| National Provider Identifier [NPI]: | 1619193620 |
| Last Name Of The Provider | PRAWAK |
| First Name Of The Provider | MYRON |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 575 N RIVER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILKES BARRE |
| Zip Code Of The Provider | 187640999 |
| 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 | 166 |
| Number Of Services | 10044 |
| Number Of Medicare Beneficiaries | 5444 |
| Total Submitted Charge Amount | 776707 |
| Total Medicare Allowed Amount | 239969.2 |
| Total Medicare Payment Amount | 190395.87 |
| Total Medicare Standardized Payment Amount | 196535.37 |
| 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 | 166 |
| Number Of Medical Services | 10044 |
| Number Of Medicare Beneficiaries With Medical Services | 5444 |
| Total Medical Submitted Charge Amount | 776707 |
| Total Medical Medicare Allowed Amount | 239969.2 |
| Total Medical Medicare Payment Amount | 190395.87 |
| Total Medical Medicare Standardized Payment Amount | 196535.37 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 786 |
| Number Of Beneficiaries Age 65 to 74 | 2097 |
| Number Of Beneficiaries Age 75 to 84 | 1592 |
| Number Of Beneficiaries Age Greater 84 | 969 |
| Number Of Female Beneficiaries | 3901 |
| Number Of Male Beneficiaries | 1543 |
| Number Of Non Hispanic White Beneficiaries | 5240 |
| Number Of Black or African American Beneficiaries | 76 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 70 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4185 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1259 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.379 |