| National Provider Identifier [NPI]: | 1447298773 |
| Last Name Of The Provider | LISCHKE |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9339 GENESEE AVE |
| Street Address 2 Of The Provider | STE 220 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921212121 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Obstetrics/Gynecology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 1641 |
| Number Of Medicare Beneficiaries | 340 |
| Total Submitted Charge Amount | 192491 |
| Total Medicare Allowed Amount | 99733.74 |
| Total Medicare Payment Amount | 78858.43 |
| Total Medicare Standardized Payment Amount | 77192.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 323 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 6531 |
| Total Drug Medicare AllowedAmount | 4423.43 |
| Total Drug Medicare PaymentAmount | 3466.32 |
| Total Drug Medicare Standardized Payment Amount | 3466.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 1318 |
| Number Of Medicare Beneficiaries With Medical Services | 340 |
| Total Medical Submitted Charge Amount | 185960 |
| Total Medical Medicare Allowed Amount | 95310.31 |
| Total Medical Medicare Payment Amount | 75392.11 |
| Total Medical Medicare Standardized Payment Amount | 73725.72 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 109 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 340 |
| Number Of Male Beneficiaries | 0 |
| Number Of Non Hispanic White Beneficiaries | 314 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 4 |
| Percent Of With Chronic Kidney Disease | 6 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 9 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 39 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6567 |