| National Provider Identifier [NPI]: | 1427004621 |
| Last Name Of The Provider | LIEBERMAN |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1225 WILSHIRE BOULEVARD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900172395 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 726 |
| Number Of Medicare Beneficiaries | 629 |
| Total Submitted Charge Amount | 449444 |
| Total Medicare Allowed Amount | 111675.76 |
| Total Medicare Payment Amount | 86303.42 |
| Total Medicare Standardized Payment Amount | 82479.46 |
| 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 | 29 |
| Number Of Medical Services | 726 |
| Number Of Medicare Beneficiaries With Medical Services | 629 |
| Total Medical Submitted Charge Amount | 449444 |
| Total Medical Medicare Allowed Amount | 111675.76 |
| Total Medical Medicare Payment Amount | 86303.42 |
| Total Medical Medicare Standardized Payment Amount | 82479.46 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 125 |
| Number Of Beneficiaries Age 65 to 74 | 162 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | 155 |
| Number Of Female Beneficiaries | 359 |
| Number Of Male Beneficiaries | 270 |
| Number Of Non Hispanic White Beneficiaries | 384 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | 57 |
| Number Of Hispanic Beneficiaries | 133 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 123 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 506 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 25 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.5115 |