| National Provider Identifier [NPI]: | 1487635900 |
| Last Name Of The Provider | LIE |
| First Name Of The Provider | CHIAO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8210 WALNUT HILL LN |
| Street Address 2 Of The Provider | SUITE 230 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752314405 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 1160 |
| Number Of Medicare Beneficiaries | 134 |
| Total Submitted Charge Amount | 96885 |
| Total Medicare Allowed Amount | 57439.95 |
| Total Medicare Payment Amount | 46056.35 |
| Total Medicare Standardized Payment Amount | 46060.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 102 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 9640 |
| Total Drug Medicare AllowedAmount | 5487.72 |
| Total Drug Medicare PaymentAmount | 5337.17 |
| Total Drug Medicare Standardized Payment Amount | 5337.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 1058 |
| Number Of Medicare Beneficiaries With Medical Services | 134 |
| Total Medical Submitted Charge Amount | 87245 |
| Total Medical Medicare Allowed Amount | 51952.23 |
| Total Medical Medicare Payment Amount | 40719.18 |
| Total Medical Medicare Standardized Payment Amount | 40723.48 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 0 |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | 42 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 100 |
| Number Of Male Beneficiaries | 34 |
| Number Of Non Hispanic White Beneficiaries | 119 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 134 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7886 |