| National Provider Identifier [NPI]: | 1326038159 |
| Last Name Of The Provider | LIEBERMAN |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1783 TROUP HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757015869 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 7400 |
| Number Of Medicare Beneficiaries | 1087 |
| Total Submitted Charge Amount | 2299361.5 |
| Total Medicare Allowed Amount | 323841.1 |
| Total Medicare Payment Amount | 242073.29 |
| Total Medicare Standardized Payment Amount | 253209.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3516 |
| Number Of Medicare Beneficiaries With Drug Services | 113 |
| Total Drug Submitted ChargeAmount | 71952 |
| Total Drug Medicare AllowedAmount | 18189.01 |
| Total Drug Medicare PaymentAmount | 13712.51 |
| Total Drug Medicare Standardized Payment Amount | 13712.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 3884 |
| Number Of Medicare Beneficiaries With Medical Services | 1087 |
| Total Medical Submitted Charge Amount | 2227409.5 |
| Total Medical Medicare Allowed Amount | 305652.09 |
| Total Medical Medicare Payment Amount | 228360.78 |
| Total Medical Medicare Standardized Payment Amount | 239496.6 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 109 |
| Number Of Beneficiaries Age 65 to 74 | 422 |
| Number Of Beneficiaries Age 75 to 84 | 397 |
| Number Of Beneficiaries Age Greater 84 | 159 |
| Number Of Female Beneficiaries | 510 |
| Number Of Male Beneficiaries | 577 |
| Number Of Non Hispanic White Beneficiaries | 962 |
| Number Of Black or African American Beneficiaries | 97 |
| 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 | 913 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 174 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6791 |