| National Provider Identifier [NPI]: | 1831426345 |
| Last Name Of The Provider | LIESER |
| First Name Of The Provider | ALEXIS |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1095 MARSHALL WAY |
| Street Address 2 Of The Provider | SIOTE 203 |
| City Of The Provider | PLACERVILLE |
| Zip Code Of The Provider | 956675722 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 462 |
| Number Of Medicare Beneficiaries | 406 |
| Total Submitted Charge Amount | 383539.4 |
| Total Medicare Allowed Amount | 74453.16 |
| Total Medicare Payment Amount | 56188.05 |
| Total Medicare Standardized Payment Amount | 56920.2 |
| 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 | 28 |
| Number Of Medical Services | 462 |
| Number Of Medicare Beneficiaries With Medical Services | 406 |
| Total Medical Submitted Charge Amount | 383539.4 |
| Total Medical Medicare Allowed Amount | 74453.16 |
| Total Medical Medicare Payment Amount | 56188.05 |
| Total Medical Medicare Standardized Payment Amount | 56920.2 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 94 |
| Number Of Beneficiaries Age 65 to 74 | 117 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 225 |
| Number Of Male Beneficiaries | 181 |
| Number Of Non Hispanic White Beneficiaries | 374 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 269 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 137 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.781 |