| National Provider Identifier [NPI]: | 1780828533 |
| Last Name Of The Provider | SHIPLE |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 ELMWOOD AVE |
| Street Address 2 Of The Provider | BOX 659 |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 146420001 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 578 |
| Number Of Medicare Beneficiaries | 269 |
| Total Submitted Charge Amount | 256505 |
| Total Medicare Allowed Amount | 75753.2 |
| Total Medicare Payment Amount | 57905.69 |
| Total Medicare Standardized Payment Amount | 60859.15 |
| 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 | 40 |
| Number Of Medical Services | 578 |
| Number Of Medicare Beneficiaries With Medical Services | 269 |
| Total Medical Submitted Charge Amount | 256505 |
| Total Medical Medicare Allowed Amount | 75753.2 |
| Total Medical Medicare Payment Amount | 57905.69 |
| Total Medical Medicare Standardized Payment Amount | 60859.15 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 75 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 152 |
| Number Of Male Beneficiaries | 117 |
| Number Of Non Hispanic White Beneficiaries | 177 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 123 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 146 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5082 |