| National Provider Identifier [NPI]: | 1598767352 |
| Last Name Of The Provider | IVANCHENKO |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 985 S. BUFFALO GROVE ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BUFFALO GROVE |
| Zip Code Of The Provider | 60089 |
| 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 | 13 |
| Number Of Services | 26257 |
| Number Of Medicare Beneficiaries | 631 |
| Total Submitted Charge Amount | 1327140 |
| Total Medicare Allowed Amount | 915926.74 |
| Total Medicare Payment Amount | 702162.58 |
| Total Medicare Standardized Payment Amount | 449329.03 |
| 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 | 13 |
| Number Of Medical Services | 26257 |
| Number Of Medicare Beneficiaries With Medical Services | 631 |
| Total Medical Submitted Charge Amount | 1327140 |
| Total Medical Medicare Allowed Amount | 915926.74 |
| Total Medical Medicare Payment Amount | 702162.58 |
| Total Medical Medicare Standardized Payment Amount | 449329.03 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 288 |
| Number Of Beneficiaries Age 75 to 84 | 270 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 382 |
| Number Of Male Beneficiaries | 249 |
| Number Of Non Hispanic White Beneficiaries | 588 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 229 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 402 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.1056 |