| National Provider Identifier [NPI]: | 1093873713 |
| Last Name Of The Provider | MCKIBBEN |
| First Name Of The Provider | EVERETT |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | THE LAIRD CLINIC |
| Street Address 2 Of The Provider | 103 DOCTORS PARK |
| City Of The Provider | STARKVILLE |
| Zip Code Of The Provider | 39759 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 6544 |
| Number Of Medicare Beneficiaries | 658 |
| Total Submitted Charge Amount | 336325 |
| Total Medicare Allowed Amount | 244063.8 |
| Total Medicare Payment Amount | 178273.31 |
| Total Medicare Standardized Payment Amount | 181835.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 1036 |
| Number Of Medicare Beneficiaries With Drug Services | 326 |
| Total Drug Submitted ChargeAmount | 26942 |
| Total Drug Medicare AllowedAmount | 16570.94 |
| Total Drug Medicare PaymentAmount | 14778 |
| Total Drug Medicare Standardized Payment Amount | 14778 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 5508 |
| Number Of Medicare Beneficiaries With Medical Services | 658 |
| Total Medical Submitted Charge Amount | 309383 |
| Total Medical Medicare Allowed Amount | 227492.86 |
| Total Medical Medicare Payment Amount | 163495.31 |
| Total Medical Medicare Standardized Payment Amount | 167057.02 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 226 |
| Number Of Beneficiaries Age 75 to 84 | 203 |
| Number Of Beneficiaries Age Greater 84 | 140 |
| Number Of Female Beneficiaries | 418 |
| Number Of Male Beneficiaries | 240 |
| Number Of Non Hispanic White Beneficiaries | 475 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 497 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 161 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.0625 |