National Provider Identifier [NPI]: |
1366525057 |
Last Name Of The Provider |
LIEBERMAN |
First Name Of The Provider |
JEFREY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2712 N DECATUR ROAD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DECATUR |
Zip Code Of The Provider |
30033 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
5386 |
Number Of Medicare Beneficiaries |
377 |
Total Submitted Charge Amount |
288858.62 |
Total Medicare Allowed Amount |
238446.36 |
Total Medicare Payment Amount |
172947.33 |
Total Medicare Standardized Payment Amount |
180192.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
3653 |
Number Of Medicare Beneficiaries With Drug Services |
137 |
Total Drug Submitted ChargeAmount |
141976.65 |
Total Drug Medicare AllowedAmount |
115771.86 |
Total Drug Medicare PaymentAmount |
90500.26 |
Total Drug Medicare Standardized Payment Amount |
90500.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
1733 |
Number Of Medicare Beneficiaries With Medical Services |
377 |
Total Medical Submitted Charge Amount |
146881.97 |
Total Medical Medicare Allowed Amount |
122674.5 |
Total Medical Medicare Payment Amount |
82447.07 |
Total Medical Medicare Standardized Payment Amount |
89692.22 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
187 |
Number Of Beneficiaries Age 75 to 84 |
115 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
289 |
Number Of Male Beneficiaries |
88 |
Number Of Non Hispanic White Beneficiaries |
289 |
Number Of Black or African American Beneficiaries |
72 |
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 |
361 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
20 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1191 |