| National Provider Identifier [NPI]: | 1376561787 |
| Last Name Of The Provider | TIBBS |
| First Name Of The Provider | RANDALL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 929 FRANKLIN ST SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HUNTSVILLE |
| Zip Code Of The Provider | 358014301 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 1423 |
| Number Of Medicare Beneficiaries | 452 |
| Total Submitted Charge Amount | 171476 |
| Total Medicare Allowed Amount | 111648.4 |
| Total Medicare Payment Amount | 80451.36 |
| Total Medicare Standardized Payment Amount | 93106.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 1423 |
| Number Of Medicare Beneficiaries With Medical Services | 452 |
| Total Medical Submitted Charge Amount | 171476 |
| Total Medical Medicare Allowed Amount | 111648.4 |
| Total Medical Medicare Payment Amount | 80451.36 |
| Total Medical Medicare Standardized Payment Amount | 93106.08 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 193 |
| Number Of Beneficiaries Age 75 to 84 | 137 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 266 |
| Number Of Male Beneficiaries | 186 |
| Number Of Non Hispanic White Beneficiaries | 291 |
| 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 | 385 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3009 |