| National Provider Identifier [NPI]: | 1962677229 |
| Last Name Of The Provider | LISZEWSKI |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 483 CRANBURY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAST BRUNSWICK |
| Zip Code Of The Provider | 088163610 |
| 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 | 136 |
| Number Of Services | 24636 |
| Number Of Medicare Beneficiaries | 2675 |
| Total Submitted Charge Amount | 1190632.8 |
| Total Medicare Allowed Amount | 286539.45 |
| Total Medicare Payment Amount | 216191.53 |
| Total Medicare Standardized Payment Amount | 195469.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 20780 |
| Number Of Medicare Beneficiaries With Drug Services | 212 |
| Total Drug Submitted ChargeAmount | 12028.8 |
| Total Drug Medicare AllowedAmount | 4174.24 |
| Total Drug Medicare PaymentAmount | 2966.36 |
| Total Drug Medicare Standardized Payment Amount | 2966.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 133 |
| Number Of Medical Services | 3856 |
| Number Of Medicare Beneficiaries With Medical Services | 2675 |
| Total Medical Submitted Charge Amount | 1178604 |
| Total Medical Medicare Allowed Amount | 282365.21 |
| Total Medical Medicare Payment Amount | 213225.17 |
| Total Medical Medicare Standardized Payment Amount | 192503.13 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 335 |
| Number Of Beneficiaries Age 65 to 74 | 946 |
| Number Of Beneficiaries Age 75 to 84 | 835 |
| Number Of Beneficiaries Age Greater 84 | 559 |
| Number Of Female Beneficiaries | 1601 |
| Number Of Male Beneficiaries | 1074 |
| Number Of Non Hispanic White Beneficiaries | 2036 |
| Number Of Black or African American Beneficiaries | 328 |
| Number Of AsianPacific Islander Beneficiaries | 110 |
| Number Of Hispanic Beneficiaries | 148 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 53 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2192 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 483 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9727 |