| National Provider Identifier [NPI]: | 1003886409 |
| Last Name Of The Provider | LIU |
| First Name Of The Provider | JEAN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4411 MEDICAL DR |
| Street Address 2 Of The Provider | STE 300 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782293824 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 7823 |
| Number Of Medicare Beneficiaries | 1349 |
| Total Submitted Charge Amount | 1794971.6 |
| Total Medicare Allowed Amount | 672969.6 |
| Total Medicare Payment Amount | 498189.62 |
| Total Medicare Standardized Payment Amount | 530691.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 583 |
| Number Of Medicare Beneficiaries With Drug Services | 147 |
| Total Drug Submitted ChargeAmount | 77552 |
| Total Drug Medicare AllowedAmount | 30870.83 |
| Total Drug Medicare PaymentAmount | 23946.92 |
| Total Drug Medicare Standardized Payment Amount | 23946.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 7240 |
| Number Of Medicare Beneficiaries With Medical Services | 1349 |
| Total Medical Submitted Charge Amount | 1717419.6 |
| Total Medical Medicare Allowed Amount | 642098.77 |
| Total Medical Medicare Payment Amount | 474242.7 |
| Total Medical Medicare Standardized Payment Amount | 506744.27 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 539 |
| Number Of Beneficiaries Age 75 to 84 | 510 |
| Number Of Beneficiaries Age Greater 84 | 262 |
| Number Of Female Beneficiaries | 655 |
| Number Of Male Beneficiaries | 694 |
| Number Of Non Hispanic White Beneficiaries | 1176 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 116 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1302 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3197 |