| National Provider Identifier [NPI]: | 1740439769 |
| Last Name Of The Provider | GIPSON |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3802 MANHATTON DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757019451 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 125 |
| Number Of Services | 6299 |
| Number Of Medicare Beneficiaries | 444 |
| Total Submitted Charge Amount | 445190 |
| Total Medicare Allowed Amount | 215007.74 |
| Total Medicare Payment Amount | 160980.86 |
| Total Medicare Standardized Payment Amount | 169604.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 293 |
| Number Of Medicare Beneficiaries With Drug Services | 182 |
| Total Drug Submitted ChargeAmount | 9093 |
| Total Drug Medicare AllowedAmount | 3810.38 |
| Total Drug Medicare PaymentAmount | 3569.84 |
| Total Drug Medicare Standardized Payment Amount | 3569.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 117 |
| Number Of Medical Services | 6006 |
| Number Of Medicare Beneficiaries With Medical Services | 444 |
| Total Medical Submitted Charge Amount | 436097 |
| Total Medical Medicare Allowed Amount | 211197.36 |
| Total Medical Medicare Payment Amount | 157411.02 |
| Total Medical Medicare Standardized Payment Amount | 166034.67 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 182 |
| Number Of Beneficiaries Age 75 to 84 | 148 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 262 |
| Number Of Male Beneficiaries | 182 |
| Number Of Non Hispanic White Beneficiaries | 393 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 366 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 78 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1003 |