| National Provider Identifier [NPI]: | 1609015650 |
| Last Name Of The Provider | LISCHUK |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6 GREAT BEDS WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH AMBOY |
| Zip Code Of The Provider | 088793429 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 3608 |
| Number Of Medicare Beneficiaries | 2413 |
| Total Submitted Charge Amount | 345834 |
| Total Medicare Allowed Amount | 71163.9 |
| Total Medicare Payment Amount | 53518.08 |
| Total Medicare Standardized Payment Amount | 50578.05 |
| 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 | 140 |
| Number Of Medical Services | 3608 |
| Number Of Medicare Beneficiaries With Medical Services | 2413 |
| Total Medical Submitted Charge Amount | 345834 |
| Total Medical Medicare Allowed Amount | 71163.9 |
| Total Medical Medicare Payment Amount | 53518.08 |
| Total Medical Medicare Standardized Payment Amount | 50578.05 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 543 |
| Number Of Beneficiaries Age 65 to 74 | 743 |
| Number Of Beneficiaries Age 75 to 84 | 646 |
| Number Of Beneficiaries Age Greater 84 | 481 |
| Number Of Female Beneficiaries | 1466 |
| Number Of Male Beneficiaries | 947 |
| Number Of Non Hispanic White Beneficiaries | 1843 |
| Number Of Black or African American Beneficiaries | 319 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 177 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1486 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 927 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9292 |