| National Provider Identifier [NPI]: | 1396755948 |
| Last Name Of The Provider | LAIBSTAIN |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1016 JUSTIS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHESAPEAKE |
| Zip Code Of The Provider | 23325 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 5230 |
| Number Of Medicare Beneficiaries | 416 |
| Total Submitted Charge Amount | 447737.5 |
| Total Medicare Allowed Amount | 198818.07 |
| Total Medicare Payment Amount | 151132.56 |
| Total Medicare Standardized Payment Amount | 153960.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 280 |
| Number Of Medicare Beneficiaries With Drug Services | 194 |
| Total Drug Submitted ChargeAmount | 21403 |
| Total Drug Medicare AllowedAmount | 13792.13 |
| Total Drug Medicare PaymentAmount | 13481 |
| Total Drug Medicare Standardized Payment Amount | 13481 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 4950 |
| Number Of Medicare Beneficiaries With Medical Services | 416 |
| Total Medical Submitted Charge Amount | 426334.5 |
| Total Medical Medicare Allowed Amount | 185025.94 |
| Total Medical Medicare Payment Amount | 137651.56 |
| Total Medical Medicare Standardized Payment Amount | 140479.59 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 191 |
| Number Of Beneficiaries Age 75 to 84 | 123 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 234 |
| Number Of Male Beneficiaries | 182 |
| Number Of Non Hispanic White Beneficiaries | 339 |
| Number Of Black or African American Beneficiaries | 66 |
| 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 | 394 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0061 |