| National Provider Identifier [NPI]: | 1205816014 |
| Last Name Of The Provider | SHOCKLEY |
| First Name Of The Provider | ALBEN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2211 MAYFAIR DR |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | OWENSBORO |
| Zip Code Of The Provider | 423014568 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 1647 |
| Number Of Medicare Beneficiaries | 606 |
| Total Submitted Charge Amount | 100676 |
| Total Medicare Allowed Amount | 53387.81 |
| Total Medicare Payment Amount | 33960.74 |
| Total Medicare Standardized Payment Amount | 38078.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 609 |
| Number Of Medicare Beneficiaries With Drug Services | 111 |
| Total Drug Submitted ChargeAmount | 3281 |
| Total Drug Medicare AllowedAmount | 712.31 |
| Total Drug Medicare PaymentAmount | 523.95 |
| Total Drug Medicare Standardized Payment Amount | 523.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 1038 |
| Number Of Medicare Beneficiaries With Medical Services | 606 |
| Total Medical Submitted Charge Amount | 97395 |
| Total Medical Medicare Allowed Amount | 52675.5 |
| Total Medical Medicare Payment Amount | 33436.79 |
| Total Medical Medicare Standardized Payment Amount | 37554.98 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 180 |
| Number Of Beneficiaries Age 65 to 74 | 239 |
| Number Of Beneficiaries Age 75 to 84 | 133 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 370 |
| Number Of Male Beneficiaries | 236 |
| Number Of Non Hispanic White Beneficiaries | 566 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 446 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 160 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0073 |