National Provider Identifier [NPI]: |
1629230834 |
Last Name Of The Provider |
LIBERMAN |
First Name Of The Provider |
COLIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2523 N MAPLEWOOD AVE |
Street Address 2 Of The Provider |
APT #1 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606471928 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
87 |
Number Of Services |
497 |
Number Of Medicare Beneficiaries |
415 |
Total Submitted Charge Amount |
707314 |
Total Medicare Allowed Amount |
68326.32 |
Total Medicare Payment Amount |
51492.69 |
Total Medicare Standardized Payment Amount |
51122.53 |
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 |
87 |
Number Of Medical Services |
497 |
Number Of Medicare Beneficiaries With Medical Services |
415 |
Total Medical Submitted Charge Amount |
707314 |
Total Medical Medicare Allowed Amount |
68326.32 |
Total Medical Medicare Payment Amount |
51492.69 |
Total Medical Medicare Standardized Payment Amount |
51122.53 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
106 |
Number Of Beneficiaries Age 65 to 74 |
175 |
Number Of Beneficiaries Age 75 to 84 |
97 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
221 |
Number Of Male Beneficiaries |
194 |
Number Of Non Hispanic White Beneficiaries |
378 |
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 |
290 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.7295 |