| National Provider Identifier [NPI]: | 1306068119 |
| Last Name Of The Provider | LISHNEVSKI |
| First Name Of The Provider | DIANA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 PARK CENTER DR STE 304 |
| Street Address 2 Of The Provider | |
| City Of The Provider | WADSWORTH |
| Zip Code Of The Provider | 442819482 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 530 |
| Number Of Medicare Beneficiaries | 129 |
| Total Submitted Charge Amount | 60325 |
| Total Medicare Allowed Amount | 35381.46 |
| Total Medicare Payment Amount | 24734.34 |
| Total Medicare Standardized Payment Amount | 26305.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 66 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 737 |
| Total Drug Medicare AllowedAmount | 442.43 |
| Total Drug Medicare PaymentAmount | 404.09 |
| Total Drug Medicare Standardized Payment Amount | 404.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 464 |
| Number Of Medicare Beneficiaries With Medical Services | 129 |
| Total Medical Submitted Charge Amount | 59588 |
| Total Medical Medicare Allowed Amount | 34939.03 |
| Total Medical Medicare Payment Amount | 24330.25 |
| Total Medical Medicare Standardized Payment Amount | 25901.72 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 56 |
| Number Of Beneficiaries Age 75 to 84 | 19 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 94 |
| Number Of Male Beneficiaries | 35 |
| 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 | 90 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.09 |