| National Provider Identifier [NPI]: | 1487655494 |
| Last Name Of The Provider | CHIPMAN |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1900 10TH AVE |
| Street Address 2 Of The Provider | 211 |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 319013600 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 9460.5 |
| Number Of Medicare Beneficiaries | 794 |
| Total Submitted Charge Amount | 712374.9 |
| Total Medicare Allowed Amount | 459344.25 |
| Total Medicare Payment Amount | 355028.55 |
| Total Medicare Standardized Payment Amount | 373098.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 1022.5 |
| Number Of Medicare Beneficiaries With Drug Services | 378 |
| Total Drug Submitted ChargeAmount | 52492.5 |
| Total Drug Medicare AllowedAmount | 29114.92 |
| Total Drug Medicare PaymentAmount | 27511.58 |
| Total Drug Medicare Standardized Payment Amount | 27511.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 8438 |
| Number Of Medicare Beneficiaries With Medical Services | 794 |
| Total Medical Submitted Charge Amount | 659882.4 |
| Total Medical Medicare Allowed Amount | 430229.33 |
| Total Medical Medicare Payment Amount | 327516.97 |
| Total Medical Medicare Standardized Payment Amount | 345587.04 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 263 |
| Number Of Beneficiaries Age 75 to 84 | 284 |
| Number Of Beneficiaries Age Greater 84 | 176 |
| Number Of Female Beneficiaries | 463 |
| Number Of Male Beneficiaries | 331 |
| Number Of Non Hispanic White Beneficiaries | 575 |
| Number Of Black or African American Beneficiaries | 200 |
| 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 | 684 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.3731 |