| National Provider Identifier [NPI]: | 1104827799 |
| Last Name Of The Provider | MEDWEDEFF |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5425 W SPRING CREEK PARKWAY SUITE 210 |
| Street Address 2 Of The Provider | |
| City Of The Provider | PLANO |
| Zip Code Of The Provider | 75024 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 987 |
| Number Of Medicare Beneficiaries | 182 |
| Total Submitted Charge Amount | 112780.52 |
| Total Medicare Allowed Amount | 53099.39 |
| Total Medicare Payment Amount | 39161.35 |
| Total Medicare Standardized Payment Amount | 41048.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 120 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 6458 |
| Total Drug Medicare AllowedAmount | 4516.21 |
| Total Drug Medicare PaymentAmount | 4334.56 |
| Total Drug Medicare Standardized Payment Amount | 4334.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 867 |
| Number Of Medicare Beneficiaries With Medical Services | 182 |
| Total Medical Submitted Charge Amount | 106322.52 |
| Total Medical Medicare Allowed Amount | 48583.18 |
| Total Medical Medicare Payment Amount | 34826.79 |
| Total Medical Medicare Standardized Payment Amount | 36713.78 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 147 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 143 |
| Number Of Male Beneficiaries | 39 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7028 |