| National Provider Identifier [NPI]: | 1619257508 |
| Last Name Of The Provider | GIBSON |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 945 BETHESDA DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | ZANESVILLE |
| Zip Code Of The Provider | 437010801 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 3310 |
| Number Of Medicare Beneficiaries | 814 |
| Total Submitted Charge Amount | 1048109.54 |
| Total Medicare Allowed Amount | 383557.57 |
| Total Medicare Payment Amount | 292198.89 |
| Total Medicare Standardized Payment Amount | 302144.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 97 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 44719.52 |
| Total Drug Medicare AllowedAmount | 19656.28 |
| Total Drug Medicare PaymentAmount | 15024.44 |
| Total Drug Medicare Standardized Payment Amount | 15024.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 3213 |
| Number Of Medicare Beneficiaries With Medical Services | 814 |
| Total Medical Submitted Charge Amount | 1003390.02 |
| Total Medical Medicare Allowed Amount | 363901.29 |
| Total Medical Medicare Payment Amount | 277174.45 |
| Total Medical Medicare Standardized Payment Amount | 287119.69 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 156 |
| Number Of Beneficiaries Age 65 to 74 | 313 |
| Number Of Beneficiaries Age 75 to 84 | 241 |
| Number Of Beneficiaries Age Greater 84 | 104 |
| Number Of Female Beneficiaries | 211 |
| Number Of Male Beneficiaries | 603 |
| Number Of Non Hispanic White Beneficiaries | 781 |
| Number Of Black or African American Beneficiaries | 22 |
| 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 | 601 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 213 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4609 |