| National Provider Identifier [NPI]: | 1821098724 |
| Last Name Of The Provider | GIBSON |
| First Name Of The Provider | BERNARD |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 UNIVERSITY BLVD |
| Street Address 2 Of The Provider | MAIL ROUTE 783 |
| City Of The Provider | GALVESTON |
| Zip Code Of The Provider | 775550783 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 4412 |
| Number Of Medicare Beneficiaries | 735 |
| Total Submitted Charge Amount | 631426.25 |
| Total Medicare Allowed Amount | 149583.69 |
| Total Medicare Payment Amount | 107050.62 |
| Total Medicare Standardized Payment Amount | 106186.26 |
| 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 | 68 |
| Number Of Medical Services | 4412 |
| Number Of Medicare Beneficiaries With Medical Services | 735 |
| Total Medical Submitted Charge Amount | 631426.25 |
| Total Medical Medicare Allowed Amount | 149583.69 |
| Total Medical Medicare Payment Amount | 107050.62 |
| Total Medical Medicare Standardized Payment Amount | 106186.26 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 335 |
| Number Of Beneficiaries Age 75 to 84 | 202 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 334 |
| Number Of Male Beneficiaries | 401 |
| Number Of Non Hispanic White Beneficiaries | 617 |
| Number Of Black or African American Beneficiaries | 52 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 619 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 116 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1554 |