| National Provider Identifier [NPI]: | 1477833648 |
| Last Name Of The Provider | GIBSON |
| First Name Of The Provider | CAROL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 337 MAPLE AVE E |
| Street Address 2 Of The Provider | |
| City Of The Provider | VIENNA |
| Zip Code Of The Provider | 221804717 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 388 |
| Number Of Medicare Beneficiaries | 197 |
| Total Submitted Charge Amount | 14625.67 |
| Total Medicare Allowed Amount | 13880.2 |
| Total Medicare Payment Amount | 11117.37 |
| Total Medicare Standardized Payment Amount | 12291.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 141 |
| Number Of Medicare Beneficiaries With Drug Services | 127 |
| Total Drug Submitted ChargeAmount | 3973.67 |
| Total Drug Medicare AllowedAmount | 3973.67 |
| Total Drug Medicare PaymentAmount | 3861.42 |
| Total Drug Medicare Standardized Payment Amount | 3861.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 247 |
| Number Of Medicare Beneficiaries With Medical Services | 197 |
| Total Medical Submitted Charge Amount | 10652 |
| Total Medical Medicare Allowed Amount | 9906.53 |
| Total Medical Medicare Payment Amount | 7255.95 |
| Total Medical Medicare Standardized Payment Amount | 8430.2 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 137 |
| Number Of Beneficiaries Age 75 to 84 | 42 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 117 |
| Number Of Male Beneficiaries | 80 |
| Number Of Non Hispanic White Beneficiaries | 155 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 6 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 7 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 39 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6103 |