| National Provider Identifier [NPI]: | 1215159744 |
| Last Name Of The Provider | LYSTILA |
| First Name Of The Provider | AJA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2512 HURST DR. |
| Street Address 2 Of The Provider | FAMILY MEDICINE |
| City Of The Provider | MATTOON |
| Zip Code Of The Provider | 619389388 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 148 |
| Number Of Services | 12657 |
| Number Of Medicare Beneficiaries | 770 |
| Total Submitted Charge Amount | 640925.9 |
| Total Medicare Allowed Amount | 283037.63 |
| Total Medicare Payment Amount | 213305.91 |
| Total Medicare Standardized Payment Amount | 218262.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 58 |
| Number Of Drug Services | 9751 |
| Number Of Medicare Beneficiaries With Drug Services | 448 |
| Total Drug Submitted ChargeAmount | 265071.36 |
| Total Drug Medicare AllowedAmount | 133018.46 |
| Total Drug Medicare PaymentAmount | 108365.82 |
| Total Drug Medicare Standardized Payment Amount | 108365.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 90 |
| Number Of Medical Services | 2906 |
| Number Of Medicare Beneficiaries With Medical Services | 767 |
| Total Medical Submitted Charge Amount | 375854.54 |
| Total Medical Medicare Allowed Amount | 150019.17 |
| Total Medical Medicare Payment Amount | 104940.09 |
| Total Medical Medicare Standardized Payment Amount | 109897.09 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 146 |
| Number Of Beneficiaries Age 65 to 74 | 285 |
| Number Of Beneficiaries Age 75 to 84 | 220 |
| Number Of Beneficiaries Age Greater 84 | 119 |
| Number Of Female Beneficiaries | 505 |
| Number Of Male Beneficiaries | 265 |
| Number Of Non Hispanic White Beneficiaries | 752 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 598 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 172 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2864 |