National Provider Identifier [NPI]: |
1316190507 |
Last Name Of The Provider |
GIBSON |
First Name Of The Provider |
SONIA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9960 CENTRAL PARK BLVD N |
Street Address 2 Of The Provider |
SUITE 150A |
City Of The Provider |
BOCA RATON |
Zip Code Of The Provider |
334281759 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Endocrinology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
298 |
Number Of Medicare Beneficiaries |
140 |
Total Submitted Charge Amount |
83012.32 |
Total Medicare Allowed Amount |
33687.04 |
Total Medicare Payment Amount |
25891.81 |
Total Medicare Standardized Payment Amount |
24605.59 |
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 |
16 |
Number Of Medical Services |
298 |
Number Of Medicare Beneficiaries With Medical Services |
140 |
Total Medical Submitted Charge Amount |
83012.32 |
Total Medical Medicare Allowed Amount |
33687.04 |
Total Medical Medicare Payment Amount |
25891.81 |
Total Medical Medicare Standardized Payment Amount |
24605.59 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
15 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
35 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
46 |
Number Of Non Hispanic White Beneficiaries |
119 |
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 |
112 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
67 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5771 |