| National Provider Identifier [NPI]: | 1548274343 |
| Last Name Of The Provider | GERSBACH |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2645 BURDEN CREEK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | JOHNS ISLAND |
| Zip Code Of The Provider | 294554604 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 149 |
| Number Of Services | 5512 |
| Number Of Medicare Beneficiaries | 946 |
| Total Submitted Charge Amount | 356086.89 |
| Total Medicare Allowed Amount | 168288.66 |
| Total Medicare Payment Amount | 118513.53 |
| Total Medicare Standardized Payment Amount | 128363.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 27 |
| Number Of Drug Services | 1956 |
| Number Of Medicare Beneficiaries With Drug Services | 283 |
| Total Drug Submitted ChargeAmount | 7487.95 |
| Total Drug Medicare AllowedAmount | 2348.94 |
| Total Drug Medicare PaymentAmount | 1653.61 |
| Total Drug Medicare Standardized Payment Amount | 1653.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 122 |
| Number Of Medical Services | 3556 |
| Number Of Medicare Beneficiaries With Medical Services | 946 |
| Total Medical Submitted Charge Amount | 348598.94 |
| Total Medical Medicare Allowed Amount | 165939.72 |
| Total Medical Medicare Payment Amount | 116859.92 |
| Total Medical Medicare Standardized Payment Amount | 126710.09 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 198 |
| Number Of Beneficiaries Age 65 to 74 | 425 |
| Number Of Beneficiaries Age 75 to 84 | 225 |
| Number Of Beneficiaries Age Greater 84 | 98 |
| Number Of Female Beneficiaries | 587 |
| Number Of Male Beneficiaries | 359 |
| Number Of Non Hispanic White Beneficiaries | 729 |
| Number Of Black or African American Beneficiaries | 189 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 807 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 139 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0098 |