| National Provider Identifier [NPI]: | 1093708588 |
| Last Name Of The Provider | LIJEWSKI |
| First Name Of The Provider | KERITH |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1687 E DIVISION ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | RIVER FALLS |
| Zip Code Of The Provider | 540221571 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 1898 |
| Number Of Medicare Beneficiaries | 376 |
| Total Submitted Charge Amount | 230846.89 |
| Total Medicare Allowed Amount | 78868.07 |
| Total Medicare Payment Amount | 58129.64 |
| Total Medicare Standardized Payment Amount | 60655.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 288 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 7100.56 |
| Total Drug Medicare AllowedAmount | 5484.91 |
| Total Drug Medicare PaymentAmount | 4505.14 |
| Total Drug Medicare Standardized Payment Amount | 4505.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 99 |
| Number Of Medical Services | 1610 |
| Number Of Medicare Beneficiaries With Medical Services | 376 |
| Total Medical Submitted Charge Amount | 223746.33 |
| Total Medical Medicare Allowed Amount | 73383.16 |
| Total Medical Medicare Payment Amount | 53624.5 |
| Total Medical Medicare Standardized Payment Amount | 56149.96 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 148 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 231 |
| Number Of Male Beneficiaries | 145 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 270 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 106 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1139 |