| National Provider Identifier [NPI]: | 1740263052 |
| Last Name Of The Provider | IVESTER |
| First Name Of The Provider | KELLY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1415 TULANE AVE |
| Street Address 2 Of The Provider | HC 71 |
| City Of The Provider | NEW ORLEANS |
| Zip Code Of The Provider | 701122600 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 242 |
| Number Of Services | 5349 |
| Number Of Medicare Beneficiaries | 3025 |
| Total Submitted Charge Amount | 507854 |
| Total Medicare Allowed Amount | 200732.01 |
| Total Medicare Payment Amount | 156412.77 |
| Total Medicare Standardized Payment Amount | 165243.15 |
| 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 | 242 |
| Number Of Medical Services | 5349 |
| Number Of Medicare Beneficiaries With Medical Services | 3025 |
| Total Medical Submitted Charge Amount | 507854 |
| Total Medical Medicare Allowed Amount | 200732.01 |
| Total Medical Medicare Payment Amount | 156412.77 |
| Total Medical Medicare Standardized Payment Amount | 165243.15 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 444 |
| Number Of Beneficiaries Age 65 to 74 | 1094 |
| Number Of Beneficiaries Age 75 to 84 | 965 |
| Number Of Beneficiaries Age Greater 84 | 522 |
| Number Of Female Beneficiaries | 1901 |
| Number Of Male Beneficiaries | 1124 |
| Number Of Non Hispanic White Beneficiaries | 2839 |
| Number Of Black or African American Beneficiaries | 75 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 49 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2489 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 536 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.277 |