| National Provider Identifier [NPI]: | 1346315140 |
| Last Name Of The Provider | LALIBERTE |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 60 HOSPITAL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEOMINSTER |
| Zip Code Of The Provider | 014532205 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 641 |
| Number Of Medicare Beneficiaries | 383 |
| Total Submitted Charge Amount | 73782 |
| Total Medicare Allowed Amount | 44876.98 |
| Total Medicare Payment Amount | 31938.67 |
| Total Medicare Standardized Payment Amount | 37471.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 51 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 361 |
| Total Drug Medicare AllowedAmount | 270.79 |
| Total Drug Medicare PaymentAmount | 238.69 |
| Total Drug Medicare Standardized Payment Amount | 238.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 590 |
| Number Of Medicare Beneficiaries With Medical Services | 380 |
| Total Medical Submitted Charge Amount | 73421 |
| Total Medical Medicare Allowed Amount | 44606.19 |
| Total Medical Medicare Payment Amount | 31699.98 |
| Total Medical Medicare Standardized Payment Amount | 37232.84 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 131 |
| Number Of Beneficiaries Age 75 to 84 | 99 |
| Number Of Beneficiaries Age Greater 84 | 49 |
| Number Of Female Beneficiaries | 263 |
| Number Of Male Beneficiaries | 120 |
| Number Of Non Hispanic White Beneficiaries | 343 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 255 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 128 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0308 |