| National Provider Identifier [NPI]: | 1154498525 |
| Last Name Of The Provider | GIBSON |
| First Name Of The Provider | RONALD |
| 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 | 360 E CHICAGO ST |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | COLDWATER |
| Zip Code Of The Provider | 490362086 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 5473 |
| Number Of Medicare Beneficiaries | 1679 |
| Total Submitted Charge Amount | 465210.5 |
| Total Medicare Allowed Amount | 271423.72 |
| Total Medicare Payment Amount | 199614.34 |
| Total Medicare Standardized Payment Amount | 202756.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 457.5 |
| Total Drug Medicare AllowedAmount | 93.31 |
| Total Drug Medicare PaymentAmount | 68.23 |
| Total Drug Medicare Standardized Payment Amount | 68.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 5439 |
| Number Of Medicare Beneficiaries With Medical Services | 1679 |
| Total Medical Submitted Charge Amount | 464753 |
| Total Medical Medicare Allowed Amount | 271330.41 |
| Total Medical Medicare Payment Amount | 199546.11 |
| Total Medical Medicare Standardized Payment Amount | 202688.14 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 282 |
| Number Of Beneficiaries Age 65 to 74 | 605 |
| Number Of Beneficiaries Age 75 to 84 | 526 |
| Number Of Beneficiaries Age Greater 84 | 266 |
| Number Of Female Beneficiaries | 932 |
| Number Of Male Beneficiaries | 747 |
| Number Of Non Hispanic White Beneficiaries | 1636 |
| 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 | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1277 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 402 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4508 |