| National Provider Identifier [NPI]: | 1548220288 |
| Last Name Of The Provider | GIBSON |
| First Name Of The Provider | SANDY |
| 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 | 2201 E MAIN ST |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232237071 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 3244 |
| Number Of Medicare Beneficiaries | 583 |
| Total Submitted Charge Amount | 539078.04 |
| Total Medicare Allowed Amount | 359155.29 |
| Total Medicare Payment Amount | 275098.24 |
| Total Medicare Standardized Payment Amount | 280989.91 |
| 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 | 24 |
| Number Of Medical Services | 3244 |
| Number Of Medicare Beneficiaries With Medical Services | 583 |
| Total Medical Submitted Charge Amount | 539078.04 |
| Total Medical Medicare Allowed Amount | 359155.29 |
| Total Medical Medicare Payment Amount | 275098.24 |
| Total Medical Medicare Standardized Payment Amount | 280989.91 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 178 |
| Number Of Beneficiaries Age 65 to 74 | 184 |
| Number Of Beneficiaries Age 75 to 84 | 137 |
| Number Of Beneficiaries Age Greater 84 | 84 |
| Number Of Female Beneficiaries | 296 |
| Number Of Male Beneficiaries | 287 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 389 |
| 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 | 380 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 203 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 59 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 69 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 4.2069 |