| National Provider Identifier [NPI]: | 1194943399 |
| Last Name Of The Provider | LISI |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5900 S LAKE DR |
| Street Address 2 Of The Provider | PULMONARY AND CRITICAL CARE |
| City Of The Provider | CUDAHY |
| Zip Code Of The Provider | 531103171 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Osteopathic Manipulative Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 2682 |
| Number Of Medicare Beneficiaries | 724 |
| Total Submitted Charge Amount | 819707 |
| Total Medicare Allowed Amount | 278551.71 |
| Total Medicare Payment Amount | 215169.55 |
| Total Medicare Standardized Payment Amount | 225422.27 |
| 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 | 45 |
| Number Of Medical Services | 2682 |
| Number Of Medicare Beneficiaries With Medical Services | 724 |
| Total Medical Submitted Charge Amount | 819707 |
| Total Medical Medicare Allowed Amount | 278551.71 |
| Total Medical Medicare Payment Amount | 215169.55 |
| Total Medical Medicare Standardized Payment Amount | 225422.27 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 132 |
| Number Of Beneficiaries Age 65 to 74 | 236 |
| Number Of Beneficiaries Age 75 to 84 | 234 |
| Number Of Beneficiaries Age Greater 84 | 122 |
| Number Of Female Beneficiaries | 402 |
| Number Of Male Beneficiaries | 322 |
| Number Of Non Hispanic White Beneficiaries | 634 |
| Number Of Black or African American Beneficiaries | 44 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 498 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 226 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 24 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 62 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 58 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.4842 |