| National Provider Identifier [NPI]: | 1013068881 |
| Last Name Of The Provider | GIBSON |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7500 HUGH DANIEL DR |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352427148 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 25637 |
| Number Of Medicare Beneficiaries | 548 |
| Total Submitted Charge Amount | 1949275.38 |
| Total Medicare Allowed Amount | 944040.26 |
| Total Medicare Payment Amount | 771457.77 |
| Total Medicare Standardized Payment Amount | 806068.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 5601 |
| Number Of Medicare Beneficiaries With Drug Services | 299 |
| Total Drug Submitted ChargeAmount | 129533 |
| Total Drug Medicare AllowedAmount | 28970.02 |
| Total Drug Medicare PaymentAmount | 22451.86 |
| Total Drug Medicare Standardized Payment Amount | 22451.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 20036 |
| Number Of Medicare Beneficiaries With Medical Services | 548 |
| Total Medical Submitted Charge Amount | 1819742.38 |
| Total Medical Medicare Allowed Amount | 915070.24 |
| Total Medical Medicare Payment Amount | 749005.91 |
| Total Medical Medicare Standardized Payment Amount | 783616.55 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 294 |
| Number Of Beneficiaries Age 65 to 74 | 173 |
| Number Of Beneficiaries Age 75 to 84 | 69 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 327 |
| Number Of Male Beneficiaries | 221 |
| Number Of Non Hispanic White Beneficiaries | 500 |
| 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 | 444 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1461 |