| National Provider Identifier [NPI]: | 1043478605 |
| Last Name Of The Provider | IVANSCO |
| First Name Of The Provider | LILLIAN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D., M.P.H. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 501 E HAMPDEN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ENGLEWOOD |
| Zip Code Of The Provider | 801132702 |
| 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 | 94 |
| Number Of Services | 2262 |
| Number Of Medicare Beneficiaries | 1261 |
| Total Submitted Charge Amount | 264171 |
| Total Medicare Allowed Amount | 83249.35 |
| Total Medicare Payment Amount | 71014.85 |
| Total Medicare Standardized Payment Amount | 71086.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 196 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 1148 |
| Total Drug Medicare AllowedAmount | 279.45 |
| Total Drug Medicare PaymentAmount | 219.07 |
| Total Drug Medicare Standardized Payment Amount | 219.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 2066 |
| Number Of Medicare Beneficiaries With Medical Services | 1261 |
| Total Medical Submitted Charge Amount | 263023 |
| Total Medical Medicare Allowed Amount | 82969.9 |
| Total Medical Medicare Payment Amount | 70795.78 |
| Total Medical Medicare Standardized Payment Amount | 70867.48 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 175 |
| Number Of Beneficiaries Age 65 to 74 | 639 |
| Number Of Beneficiaries Age 75 to 84 | 296 |
| Number Of Beneficiaries Age Greater 84 | 151 |
| Number Of Female Beneficiaries | 974 |
| Number Of Male Beneficiaries | 287 |
| Number Of Non Hispanic White Beneficiaries | 958 |
| Number Of Black or African American Beneficiaries | 214 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1052 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 209 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5852 |