| National Provider Identifier [NPI]: | 1487824660 |
| Last Name Of The Provider | LIBERATOR |
| First Name Of The Provider | LORI |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8332 W THUNDERBIRD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PEORIA |
| Zip Code Of The Provider | 853814822 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 277 |
| Number Of Medicare Beneficiaries | 145 |
| Total Submitted Charge Amount | 11726.04 |
| Total Medicare Allowed Amount | 10569.86 |
| Total Medicare Payment Amount | 8190.34 |
| Total Medicare Standardized Payment Amount | 9393.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 96 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 3430.04 |
| Total Drug Medicare AllowedAmount | 3252.2 |
| Total Drug Medicare PaymentAmount | 3187.15 |
| Total Drug Medicare Standardized Payment Amount | 3187.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 181 |
| Number Of Medicare Beneficiaries With Medical Services | 145 |
| Total Medical Submitted Charge Amount | 8296 |
| Total Medical Medicare Allowed Amount | 7317.66 |
| Total Medical Medicare Payment Amount | 5003.19 |
| Total Medical Medicare Standardized Payment Amount | 6206.14 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 92 |
| Number Of Male Beneficiaries | 53 |
| Number Of Non Hispanic White Beneficiaries | 130 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.799 |