| National Provider Identifier [NPI]: | 1770582041 |
| Last Name Of The Provider | SHIRLEY |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 495 HOGAN LANE |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | CONWAY |
| Zip Code Of The Provider | 72034 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 5695 |
| Number Of Medicare Beneficiaries | 793 |
| Total Submitted Charge Amount | 785993 |
| Total Medicare Allowed Amount | 376734.24 |
| Total Medicare Payment Amount | 285935.8 |
| Total Medicare Standardized Payment Amount | 304214.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 1144 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 192706.5 |
| Total Drug Medicare AllowedAmount | 113322.94 |
| Total Drug Medicare PaymentAmount | 87984.55 |
| Total Drug Medicare Standardized Payment Amount | 87984.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 4551 |
| Number Of Medicare Beneficiaries With Medical Services | 793 |
| Total Medical Submitted Charge Amount | 593286.5 |
| Total Medical Medicare Allowed Amount | 263411.3 |
| Total Medical Medicare Payment Amount | 197951.25 |
| Total Medical Medicare Standardized Payment Amount | 216230.25 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 92 |
| Number Of Beneficiaries Age 65 to 74 | 312 |
| Number Of Beneficiaries Age 75 to 84 | 291 |
| Number Of Beneficiaries Age Greater 84 | 98 |
| Number Of Female Beneficiaries | 222 |
| Number Of Male Beneficiaries | 571 |
| Number Of Non Hispanic White Beneficiaries | 757 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 695 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 98 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1554 |