| National Provider Identifier [NPI]: | 1841408200 |
| Last Name Of The Provider | SHIPLEY |
| First Name Of The Provider | KYLE |
| 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 | 3226 S ALAMEDA ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CORPUS CHRISTI |
| Zip Code Of The Provider | 784042508 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 193 |
| Number Of Services | 7408 |
| Number Of Medicare Beneficiaries | 2412 |
| Total Submitted Charge Amount | 712723.7 |
| Total Medicare Allowed Amount | 233204.35 |
| Total Medicare Payment Amount | 178649.24 |
| Total Medicare Standardized Payment Amount | 193698.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3837 |
| Number Of Medicare Beneficiaries With Drug Services | 132 |
| Total Drug Submitted ChargeAmount | 3588.6 |
| Total Drug Medicare AllowedAmount | 1596.43 |
| Total Drug Medicare PaymentAmount | 1234.75 |
| Total Drug Medicare Standardized Payment Amount | 1234.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 190 |
| Number Of Medical Services | 3571 |
| Number Of Medicare Beneficiaries With Medical Services | 2410 |
| Total Medical Submitted Charge Amount | 709135.1 |
| Total Medical Medicare Allowed Amount | 231607.92 |
| Total Medical Medicare Payment Amount | 177414.49 |
| Total Medical Medicare Standardized Payment Amount | 192463.53 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 714 |
| Number Of Beneficiaries Age 65 to 74 | 856 |
| Number Of Beneficiaries Age 75 to 84 | 547 |
| Number Of Beneficiaries Age Greater 84 | 295 |
| Number Of Female Beneficiaries | 1463 |
| Number Of Male Beneficiaries | 949 |
| Number Of Non Hispanic White Beneficiaries | 1128 |
| Number Of Black or African American Beneficiaries | 103 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 1142 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1499 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 913 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0175 |