| National Provider Identifier [NPI]: | 1730491192 |
| Last Name Of The Provider | TANAKA |
| First Name Of The Provider | IWAO |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 700 HIGH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILLIAMSPORT |
| Zip Code Of The Provider | 177013100 |
| 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 | 192 |
| Number Of Services | 6825 |
| Number Of Medicare Beneficiaries | 3920 |
| Total Submitted Charge Amount | 808936 |
| Total Medicare Allowed Amount | 184407.63 |
| Total Medicare Payment Amount | 143452.16 |
| Total Medicare Standardized Payment Amount | 147682.74 |
| 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 | 192 |
| Number Of Medical Services | 6825 |
| Number Of Medicare Beneficiaries With Medical Services | 3920 |
| Total Medical Submitted Charge Amount | 808936 |
| Total Medical Medicare Allowed Amount | 184407.63 |
| Total Medical Medicare Payment Amount | 143452.16 |
| Total Medical Medicare Standardized Payment Amount | 147682.74 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 715 |
| Number Of Beneficiaries Age 65 to 74 | 1369 |
| Number Of Beneficiaries Age 75 to 84 | 1142 |
| Number Of Beneficiaries Age Greater 84 | 694 |
| Number Of Female Beneficiaries | 2435 |
| Number Of Male Beneficiaries | 1485 |
| Number Of Non Hispanic White Beneficiaries | 3760 |
| Number Of Black or African American Beneficiaries | 110 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2994 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 926 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4304 |