| National Provider Identifier [NPI]: | 1588862817 |
| Last Name Of The Provider | LABIB |
| First Name Of The Provider | MARY |
| 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 | 3355 RIVERBEND DR |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 974778800 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 3678.8 |
| Number Of Medicare Beneficiaries | 599 |
| Total Submitted Charge Amount | 320712 |
| Total Medicare Allowed Amount | 299266.51 |
| Total Medicare Payment Amount | 225360.7 |
| Total Medicare Standardized Payment Amount | 229339.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1496.8 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 22431 |
| Total Drug Medicare AllowedAmount | 17115.62 |
| Total Drug Medicare PaymentAmount | 12860.74 |
| Total Drug Medicare Standardized Payment Amount | 12860.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 2182 |
| Number Of Medicare Beneficiaries With Medical Services | 599 |
| Total Medical Submitted Charge Amount | 298281 |
| Total Medical Medicare Allowed Amount | 282150.89 |
| Total Medical Medicare Payment Amount | 212499.96 |
| Total Medical Medicare Standardized Payment Amount | 216479 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 195 |
| Number Of Beneficiaries Age 65 to 74 | 193 |
| Number Of Beneficiaries Age 75 to 84 | 138 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 286 |
| Number Of Male Beneficiaries | 313 |
| Number Of Non Hispanic White Beneficiaries | 533 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 392 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 207 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 5.187 |