| National Provider Identifier [NPI]: | 1922267327 |
| Last Name Of The Provider | HIBBARD |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7000 STONEWOOD DR |
| Street Address 2 Of The Provider | STE 151 |
| City Of The Provider | WEXFORD |
| Zip Code Of The Provider | 15090 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 3052 |
| Number Of Medicare Beneficiaries | 562 |
| Total Submitted Charge Amount | 336139 |
| Total Medicare Allowed Amount | 127850.66 |
| Total Medicare Payment Amount | 95952.57 |
| Total Medicare Standardized Payment Amount | 94574.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 1707 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 21810 |
| Total Drug Medicare AllowedAmount | 9666.51 |
| Total Drug Medicare PaymentAmount | 7578.53 |
| Total Drug Medicare Standardized Payment Amount | 7578.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 1345 |
| Number Of Medicare Beneficiaries With Medical Services | 562 |
| Total Medical Submitted Charge Amount | 314329 |
| Total Medical Medicare Allowed Amount | 118184.15 |
| Total Medical Medicare Payment Amount | 88374.04 |
| Total Medical Medicare Standardized Payment Amount | 86995.77 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 385 |
| Number Of Beneficiaries Age 65 to 74 | 110 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 329 |
| Number Of Male Beneficiaries | 233 |
| Number Of Non Hispanic White Beneficiaries | 520 |
| Number Of Black or African American Beneficiaries | 30 |
| 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 | 289 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 273 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2946 |