| National Provider Identifier [NPI]: | 1841203478 |
| Last Name Of The Provider | GIPSON |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | PHYS ASSIST CERT |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3015 N BALLAS RD |
| Street Address 2 Of The Provider | DEPARTMENT OF CRITICAL CARE |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631312329 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 313 |
| Number Of Medicare Beneficiaries | 275 |
| Total Submitted Charge Amount | 75061 |
| Total Medicare Allowed Amount | 15658.27 |
| Total Medicare Payment Amount | 11932.8 |
| Total Medicare Standardized Payment Amount | 14272.19 |
| 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 | 12 |
| Number Of Medical Services | 313 |
| Number Of Medicare Beneficiaries With Medical Services | 275 |
| Total Medical Submitted Charge Amount | 75061 |
| Total Medical Medicare Allowed Amount | 15658.27 |
| Total Medical Medicare Payment Amount | 11932.8 |
| Total Medical Medicare Standardized Payment Amount | 14272.19 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 71 |
| Number Of Beneficiaries Age 75 to 84 | 91 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 176 |
| Number Of Male Beneficiaries | 99 |
| Number Of Non Hispanic White Beneficiaries | 227 |
| 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 | 205 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 23 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 61 |
| Percent Of With Chronic Kidney Disease | 63 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 3.2495 |