| National Provider Identifier [NPI]: | 1790982437 |
| Last Name Of The Provider | JAWORSKY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 369 E MAIN ST |
| Street Address 2 Of The Provider | SUITE 18 |
| City Of The Provider | EAST ISLIP |
| Zip Code Of The Provider | 117302800 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 17511 |
| Number Of Medicare Beneficiaries | 976 |
| Total Submitted Charge Amount | 877000.35 |
| Total Medicare Allowed Amount | 252559.4 |
| Total Medicare Payment Amount | 189848.67 |
| Total Medicare Standardized Payment Amount | 163912.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 15700 |
| Number Of Medicare Beneficiaries With Drug Services | 190 |
| Total Drug Submitted ChargeAmount | 6243.35 |
| Total Drug Medicare AllowedAmount | 3768.52 |
| Total Drug Medicare PaymentAmount | 2930.13 |
| Total Drug Medicare Standardized Payment Amount | 2930.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 115 |
| Number Of Medical Services | 1811 |
| Number Of Medicare Beneficiaries With Medical Services | 976 |
| Total Medical Submitted Charge Amount | 870757 |
| Total Medical Medicare Allowed Amount | 248790.88 |
| Total Medical Medicare Payment Amount | 186918.54 |
| Total Medical Medicare Standardized Payment Amount | 160982.37 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 400 |
| Number Of Beneficiaries Age 75 to 84 | 342 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 587 |
| Number Of Male Beneficiaries | 389 |
| Number Of Non Hispanic White Beneficiaries | 853 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 861 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 115 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2936 |