| National Provider Identifier [NPI]: | 1114033057 |
| Last Name Of The Provider | LIBBY |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 407 E 70TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW YORK |
| Zip Code Of The Provider | 100215311 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 19303 |
| Number Of Medicare Beneficiaries | 1076 |
| Total Submitted Charge Amount | 816336.05 |
| Total Medicare Allowed Amount | 743272.09 |
| Total Medicare Payment Amount | 597749.66 |
| Total Medicare Standardized Payment Amount | 556141.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1447 |
| Number Of Medicare Beneficiaries With Drug Services | 261 |
| Total Drug Submitted ChargeAmount | 44245.36 |
| Total Drug Medicare AllowedAmount | 44245.36 |
| Total Drug Medicare PaymentAmount | 38030.02 |
| Total Drug Medicare Standardized Payment Amount | 38030.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 17856 |
| Number Of Medicare Beneficiaries With Medical Services | 1075 |
| Total Medical Submitted Charge Amount | 772090.69 |
| Total Medical Medicare Allowed Amount | 699026.73 |
| Total Medical Medicare Payment Amount | 559719.64 |
| Total Medical Medicare Standardized Payment Amount | 518111.34 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 377 |
| Number Of Beneficiaries Age 75 to 84 | 469 |
| Number Of Beneficiaries Age Greater 84 | 214 |
| Number Of Female Beneficiaries | 673 |
| Number Of Male Beneficiaries | 403 |
| Number Of Non Hispanic White Beneficiaries | 1014 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1056 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 28 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.5584 |