| National Provider Identifier [NPI]: | 1992758098 |
| Last Name Of The Provider | LISKIEWICZ |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | Z |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 315 75TH ST W |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRADENTON |
| Zip Code Of The Provider | 342093201 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 152 |
| Number Of Services | 4643 |
| Number Of Medicare Beneficiaries | 1212 |
| Total Submitted Charge Amount | 400292 |
| Total Medicare Allowed Amount | 175738.35 |
| Total Medicare Payment Amount | 118006.52 |
| Total Medicare Standardized Payment Amount | 120567.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 20 |
| Number Of Drug Services | 1337 |
| Number Of Medicare Beneficiaries With Drug Services | 232 |
| Total Drug Submitted ChargeAmount | 4385 |
| Total Drug Medicare AllowedAmount | 1735.44 |
| Total Drug Medicare PaymentAmount | 1386.79 |
| Total Drug Medicare Standardized Payment Amount | 1386.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 132 |
| Number Of Medical Services | 3306 |
| Number Of Medicare Beneficiaries With Medical Services | 1212 |
| Total Medical Submitted Charge Amount | 395907 |
| Total Medical Medicare Allowed Amount | 174002.91 |
| Total Medical Medicare Payment Amount | 116619.73 |
| Total Medical Medicare Standardized Payment Amount | 119180.78 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 469 |
| Number Of Beneficiaries Age 75 to 84 | 427 |
| Number Of Beneficiaries Age Greater 84 | 251 |
| Number Of Female Beneficiaries | 739 |
| Number Of Male Beneficiaries | 473 |
| Number Of Non Hispanic White Beneficiaries | 1173 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1142 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1262 |