| National Provider Identifier [NPI]: | 1073588778 |
| Last Name Of The Provider | ISUANI |
| First Name Of The Provider | GUSTAVO |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1100 BALSAM AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOULDER |
| Zip Code Of The Provider | 803043404 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 192 |
| Number Of Services | 3751 |
| Number Of Medicare Beneficiaries | 2348 |
| Total Submitted Charge Amount | 471639.3 |
| Total Medicare Allowed Amount | 131248.29 |
| Total Medicare Payment Amount | 98376.6 |
| Total Medicare Standardized Payment Amount | 100191.66 |
| 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 | 3751 |
| Number Of Medicare Beneficiaries With Medical Services | 2348 |
| Total Medical Submitted Charge Amount | 471639.3 |
| Total Medical Medicare Allowed Amount | 131248.29 |
| Total Medical Medicare Payment Amount | 98376.6 |
| Total Medical Medicare Standardized Payment Amount | 100191.66 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 251 |
| Number Of Beneficiaries Age 65 to 74 | 1074 |
| Number Of Beneficiaries Age 75 to 84 | 685 |
| Number Of Beneficiaries Age Greater 84 | 338 |
| Number Of Female Beneficiaries | 1399 |
| Number Of Male Beneficiaries | 949 |
| Number Of Non Hispanic White Beneficiaries | 2144 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 47 |
| Number Of Hispanic Beneficiaries | 75 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 51 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2082 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 266 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2239 |