| National Provider Identifier [NPI]: | 1730199860 |
| Last Name Of The Provider | LYZANCHUK |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 611 N 39TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | YAKIMA |
| Zip Code Of The Provider | 989026348 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 1692 |
| Number Of Medicare Beneficiaries | 394 |
| Total Submitted Charge Amount | 200342 |
| Total Medicare Allowed Amount | 124929.44 |
| Total Medicare Payment Amount | 83787.01 |
| Total Medicare Standardized Payment Amount | 86762.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 94 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 1034 |
| Total Drug Medicare AllowedAmount | 216.64 |
| Total Drug Medicare PaymentAmount | 171.25 |
| Total Drug Medicare Standardized Payment Amount | 171.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1598 |
| Number Of Medicare Beneficiaries With Medical Services | 394 |
| Total Medical Submitted Charge Amount | 199308 |
| Total Medical Medicare Allowed Amount | 124712.8 |
| Total Medical Medicare Payment Amount | 83615.76 |
| Total Medical Medicare Standardized Payment Amount | 86591.46 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 180 |
| Number Of Beneficiaries Age 75 to 84 | 121 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 218 |
| Number Of Male Beneficiaries | 176 |
| Number Of Non Hispanic White Beneficiaries | 343 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 308 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0739 |