| National Provider Identifier [NPI]: | 1366450041 |
| Last Name Of The Provider | LYSIUK |
| First Name Of The Provider | LANCE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | OD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 438 MAIN ST |
| Street Address 2 Of The Provider | SUITE 204 |
| City Of The Provider | MIDDLETOWN |
| Zip Code Of The Provider | 064573396 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 3131 |
| Number Of Medicare Beneficiaries | 1809 |
| Total Submitted Charge Amount | 398719 |
| Total Medicare Allowed Amount | 342275.36 |
| Total Medicare Payment Amount | 261910.82 |
| Total Medicare Standardized Payment Amount | 242173.54 |
| 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 | 10 |
| Number Of Medical Services | 3131 |
| Number Of Medicare Beneficiaries With Medical Services | 1809 |
| Total Medical Submitted Charge Amount | 398719 |
| Total Medical Medicare Allowed Amount | 342275.36 |
| Total Medical Medicare Payment Amount | 261910.82 |
| Total Medical Medicare Standardized Payment Amount | 242173.54 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 226 |
| Number Of Beneficiaries Age 65 to 74 | 295 |
| Number Of Beneficiaries Age 75 to 84 | 410 |
| Number Of Beneficiaries Age Greater 84 | 878 |
| Number Of Female Beneficiaries | 1238 |
| Number Of Male Beneficiaries | 571 |
| Number Of Non Hispanic White Beneficiaries | 1464 |
| Number Of Black or African American Beneficiaries | 203 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 109 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 162 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1647 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 58 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 33 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.2615 |