| National Provider Identifier [NPI]: | 1306993282 |
| Last Name Of The Provider | SHIPMAN |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 25TH AVENUE NORTH |
| Street Address 2 Of The Provider | SUITE 602 |
| City Of The Provider | NASHVILLE |
| Zip Code Of The Provider | 37203 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 193 |
| Number Of Services | 5358 |
| Number Of Medicare Beneficiaries | 3801 |
| Total Submitted Charge Amount | 386372 |
| Total Medicare Allowed Amount | 124677.83 |
| Total Medicare Payment Amount | 96028.32 |
| Total Medicare Standardized Payment Amount | 102897.72 |
| 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 | 193 |
| Number Of Medical Services | 5358 |
| Number Of Medicare Beneficiaries With Medical Services | 3801 |
| Total Medical Submitted Charge Amount | 386372 |
| Total Medical Medicare Allowed Amount | 124677.83 |
| Total Medical Medicare Payment Amount | 96028.32 |
| Total Medical Medicare Standardized Payment Amount | 102897.72 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 910 |
| Number Of Beneficiaries Age 65 to 74 | 1273 |
| Number Of Beneficiaries Age 75 to 84 | 1030 |
| Number Of Beneficiaries Age Greater 84 | 588 |
| Number Of Female Beneficiaries | 2177 |
| Number Of Male Beneficiaries | 1624 |
| Number Of Non Hispanic White Beneficiaries | 3245 |
| Number Of Black or African American Beneficiaries | 464 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2660 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1141 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.925 |