| National Provider Identifier [NPI]: | 1932109931 |
| Last Name Of The Provider | LILJENQUIST |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2220 E 25TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | IDAHO FALLS |
| Zip Code Of The Provider | 834047542 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Endocrinology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 129 |
| Number Of Services | 20649 |
| Number Of Medicare Beneficiaries | 1222 |
| Total Submitted Charge Amount | 957944.53 |
| Total Medicare Allowed Amount | 423133.01 |
| Total Medicare Payment Amount | 330526.45 |
| Total Medicare Standardized Payment Amount | 354407.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 8171 |
| Number Of Medicare Beneficiaries With Drug Services | 279 |
| Total Drug Submitted ChargeAmount | 127371 |
| Total Drug Medicare AllowedAmount | 85018.68 |
| Total Drug Medicare PaymentAmount | 66531.28 |
| Total Drug Medicare Standardized Payment Amount | 66531.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 114 |
| Number Of Medical Services | 12478 |
| Number Of Medicare Beneficiaries With Medical Services | 1222 |
| Total Medical Submitted Charge Amount | 830573.53 |
| Total Medical Medicare Allowed Amount | 338114.33 |
| Total Medical Medicare Payment Amount | 263995.17 |
| Total Medical Medicare Standardized Payment Amount | 287876.36 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 185 |
| Number Of Beneficiaries Age 65 to 74 | 583 |
| Number Of Beneficiaries Age 75 to 84 | 352 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 744 |
| Number Of Male Beneficiaries | 478 |
| Number Of Non Hispanic White Beneficiaries | 1137 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 998 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 224 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 68 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 22 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3118 |