| National Provider Identifier [NPI]: | 1497872576 |
| Last Name Of The Provider | DVORAK |
| First Name Of The Provider | RYAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8303 DODGE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OMAHA |
| Zip Code Of The Provider | 681144108 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 164 |
| Number Of Services | 3698 |
| Number Of Medicare Beneficiaries | 2447 |
| Total Submitted Charge Amount | 586994 |
| Total Medicare Allowed Amount | 112790.38 |
| Total Medicare Payment Amount | 82083.98 |
| Total Medicare Standardized Payment Amount | 87798.26 |
| 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 | 164 |
| Number Of Medical Services | 3698 |
| Number Of Medicare Beneficiaries With Medical Services | 2447 |
| Total Medical Submitted Charge Amount | 586994 |
| Total Medical Medicare Allowed Amount | 112790.38 |
| Total Medical Medicare Payment Amount | 82083.98 |
| Total Medical Medicare Standardized Payment Amount | 87798.26 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 270 |
| Number Of Beneficiaries Age 65 to 74 | 920 |
| Number Of Beneficiaries Age 75 to 84 | 774 |
| Number Of Beneficiaries Age Greater 84 | 483 |
| Number Of Female Beneficiaries | 1519 |
| Number Of Male Beneficiaries | 928 |
| Number Of Non Hispanic White Beneficiaries | 2264 |
| Number Of Black or African American Beneficiaries | 100 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2087 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 360 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5513 |